Baseline Pulmonary Function as a Predictor for Survival and Decline in Pulmonary Function Over Time in Patients Undergoing Stereotactic Body Radiotherapy for the Treatment of Stage I Non-Small-Cell Lung Cancer
- Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IN (United States)
- Department of Radiation Medicine, University of Kentucky, Lexington, KY (United States)
- Division of Biostatistics, Indiana University School of Medicine, Indianapolis, IN (United States)
- Pulmonary Division, Richard L. Roudebush VA Medical Center, Indianapolis, IN (United States)
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX (United States)
Purpose: To examine the effect of baseline forced expiratory volume in 1 second (FEV{sub 1}) and diffusion capacity for carbon monoxide (DL{sub co}) on posttreatment survival and pulmonary function decrease after stereotactic body radiotherapy (SBRT) for patients with early-stage non-small-cell lung cancer (NSCLC). Methods and Materials: Seventy medically inoperable patients with Stage I NSCLC were treated with definitive SBRT to a dose of 6,000 (Stage IA) or 6,600 cGy (Stage IB), given in three equal fractions. Baseline and serial posttreatment pulmonary function data were collected. Results: Median age was 70.5 years, and median follow-up was 2.17 years. Median pretreatment FEV{sub 1} and DL{sub co} were 1.05 L and 10.06 mg/min/mm Hg, respectively. There was no significant decrease in survival in patients with baseline FEV{sub 1} and DL{sub co} less than the median value and less than the lowest quartile, whereas patients with values greater than the highest quartile of baseline FEV{sub 1} had significantly inferior survival. There was no significant effect of pretreatment FEV{sub 1} or DL{sub co} on posttreatment levels. There was a statistically significant decrease in DL{sub co} of 1.11 mg/min/mm Hg/y. Conclusions: Poor baseline pulmonary function did not predict decreased survival or pulmonary function after treatment. A statistically significant decrease in DL{sub co} after treatment was seen, similar to decreases seen in studies delivering standard thoracic radiotherapy. We conclude that low pretreatment FEV{sub 1} and/or DL{sub co} alone should not be used to exclude patients with NSCLC from treatment with SBRT.
- OSTI ID:
- 21124465
- Journal Information:
- International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 2 Vol. 72; ISSN IOBPD3; ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
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