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Title: Prospective, Risk-Adapted Strategy of Stereotactic Body Radiotherapy for Early-Stage Non-Small-Cell Lung Cancer: Results of a Phase II Trial

Abstract

Purpose: Validation of a prospective, risk-adapted strategy for early-stage non-small-cell lung cancer (NSCLC) patients treated with stereotactic body radiotherapy (SBRT). Methods and Materials: Patients with a T1-3N0M0 (American Joint Committee on Cancer 6th edition) NSCLC were accrued. Using the Radiation Therapy Oncology Group definition, patients were treated to a total dose of 60,Gy in three fractions for peripherally located lesions and four fractions for centrally located lesions. The primary endpoint was toxicity, graded according to the Radiation Therapy Oncology Group acute and late morbidity scoring system, and the National Cancer Institute Common Terminology Criteria for Adverse Events Version 3.0. Secondary endpoints were local control and survival. Results: A total of 40 patients were included, 17 with a centrally located lesion. The lung toxicity-free survival estimate at 2 years was 74% and was related to the location (central vs. peripheral) and the size of the target volume. No dose volumetric parameters could predict the occurrence of lung toxicity. One patient died because of treatment-related toxicity. The 1-year and 2-year local progression-free survival estimates were 97% and 84%, respectively, and were related to stage (T1 vs. T2) related (p = 0.006). Local failure was not more frequent for patients treated in fourmore » fractions. The 1-year local progression-free survival estimate dropped below 80% for lesions with a diameter of more than 4 cm. Conclusion: The proposed risk-adapted strategy for both centrally and peripherally located lesions showed an acceptable toxicity profile while maintaining excellent local control rates. The correlation between local control and tumor diameter calls for the inclusion of tumor stage as a variable in future study design.« less

Authors:
 [1]; ; ; ; ;  [1];  [2];  [3]; ; ;  [1]
  1. Department of Radiotherapy, University Hospital Brussels, Brussels (Belgium)
  2. Department of Radiology of the University Hospital Brussels, Brussels (Belgium)
  3. Department of Nuclear Medicine, University Hospital Brussels, Brussels (Belgium)
Publication Date:
OSTI Identifier:
21587650
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 80; Journal Issue: 5; Other Information: DOI: 10.1016/j.ijrobp.2010.04.056; PII: S0360-3016(10)00670-X; Copyright (c) 2011 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; DISEASE INCIDENCE; HAZARDS; LUNGS; NEOPLASMS; RADIATION DOSES; RADIOTHERAPY; TOXICITY; BODY; DISEASES; DOSES; MEDICINE; NUCLEAR MEDICINE; ORGANS; RADIOLOGY; RESPIRATORY SYSTEM; THERAPY

Citation Formats

Bral, Samuel, E-mail: samuelbral@yahoo.co.uk, Gevaert, Thierry, Linthout, Nadine, Versmessen, Harijati, Collen, Christine, Engels, Benedikt, Verdries, Douwe, Everaert, Hendrik, Christian, Nicolas, De Ridder, Mark, and Storme, Guy. Prospective, Risk-Adapted Strategy of Stereotactic Body Radiotherapy for Early-Stage Non-Small-Cell Lung Cancer: Results of a Phase II Trial. United States: N. p., 2011. Web. doi:10.1016/j.ijrobp.2010.04.056.
Bral, Samuel, E-mail: samuelbral@yahoo.co.uk, Gevaert, Thierry, Linthout, Nadine, Versmessen, Harijati, Collen, Christine, Engels, Benedikt, Verdries, Douwe, Everaert, Hendrik, Christian, Nicolas, De Ridder, Mark, & Storme, Guy. Prospective, Risk-Adapted Strategy of Stereotactic Body Radiotherapy for Early-Stage Non-Small-Cell Lung Cancer: Results of a Phase II Trial. United States. doi:10.1016/j.ijrobp.2010.04.056.
Bral, Samuel, E-mail: samuelbral@yahoo.co.uk, Gevaert, Thierry, Linthout, Nadine, Versmessen, Harijati, Collen, Christine, Engels, Benedikt, Verdries, Douwe, Everaert, Hendrik, Christian, Nicolas, De Ridder, Mark, and Storme, Guy. Mon . "Prospective, Risk-Adapted Strategy of Stereotactic Body Radiotherapy for Early-Stage Non-Small-Cell Lung Cancer: Results of a Phase II Trial". United States. doi:10.1016/j.ijrobp.2010.04.056.
@article{osti_21587650,
title = {Prospective, Risk-Adapted Strategy of Stereotactic Body Radiotherapy for Early-Stage Non-Small-Cell Lung Cancer: Results of a Phase II Trial},
author = {Bral, Samuel, E-mail: samuelbral@yahoo.co.uk and Gevaert, Thierry and Linthout, Nadine and Versmessen, Harijati and Collen, Christine and Engels, Benedikt and Verdries, Douwe and Everaert, Hendrik and Christian, Nicolas and De Ridder, Mark and Storme, Guy},
abstractNote = {Purpose: Validation of a prospective, risk-adapted strategy for early-stage non-small-cell lung cancer (NSCLC) patients treated with stereotactic body radiotherapy (SBRT). Methods and Materials: Patients with a T1-3N0M0 (American Joint Committee on Cancer 6th edition) NSCLC were accrued. Using the Radiation Therapy Oncology Group definition, patients were treated to a total dose of 60,Gy in three fractions for peripherally located lesions and four fractions for centrally located lesions. The primary endpoint was toxicity, graded according to the Radiation Therapy Oncology Group acute and late morbidity scoring system, and the National Cancer Institute Common Terminology Criteria for Adverse Events Version 3.0. Secondary endpoints were local control and survival. Results: A total of 40 patients were included, 17 with a centrally located lesion. The lung toxicity-free survival estimate at 2 years was 74% and was related to the location (central vs. peripheral) and the size of the target volume. No dose volumetric parameters could predict the occurrence of lung toxicity. One patient died because of treatment-related toxicity. The 1-year and 2-year local progression-free survival estimates were 97% and 84%, respectively, and were related to stage (T1 vs. T2) related (p = 0.006). Local failure was not more frequent for patients treated in four fractions. The 1-year local progression-free survival estimate dropped below 80% for lesions with a diameter of more than 4 cm. Conclusion: The proposed risk-adapted strategy for both centrally and peripherally located lesions showed an acceptable toxicity profile while maintaining excellent local control rates. The correlation between local control and tumor diameter calls for the inclusion of tumor stage as a variable in future study design.},
doi = {10.1016/j.ijrobp.2010.04.056},
journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 5,
volume = 80,
place = {United States},
year = {2011},
month = {8}
}