Stereotactic Body Radiotherapy (SBRT) for Operable Stage I Non-Small-Cell Lung Cancer: Can SBRT Be Comparable to Surgery?

Journal Article · Thu Dec 01 04:00:00 EST 2011 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/J.IJROBP.2009.07.1751· OSTI ID:22054487

Onishi, Hiroshi ^[1]; Shirato, Hiroki ^[2]; Nagata, Yasushi ^[3]; Hiraoka, Masahiro ^[4]; Fujino, Masaharu ^[2]; Gomi, Kotaro ^[5]; Karasawa, Katsuyuki ^[6]; Hayakawa, Kazushige; Niibe, Yuzuru ^[7]; Takai, Yoshihiro ^[8]; Kimura, Tomoki ^[9]; Takeda, Atsuya ^[10]; Ouchi, Atsushi ^[11]; Hareyama, Masato ^[12]; Kokubo, Masaki ^[13]; Kozuka, Takuyo ^[14]; Arimoto, Takuro ^[15]; Hara, Ryusuke ^[16]; Itami, Jun ^[17]; Araki, Tsutomu ^[1]

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1. School of Medicine, Yamanashi University, Yamanashi (Japan)
2. School of Medicine, Hokkaido University, Sapporo (Japan)
3. School of Medicine, Hiroshima University, Hiroshima (Japan)
4. School of Medicine, Kyoto University, Kyoto (Japan)
5. Cancer Institute Suwa Red-Cross Hospital, Suwa (Japan)
6. Tokyo Metropolitan Komagome Hospital, Tokyo (Japan)
7. Kitasato University, Kanagawa (Japan)
8. School of Medicine, Hirosaki University, Hirosaki (Japan)
9. School of Medicine, Kagawa University, Hiroshima (Japan)
10. Ofuna Chuo Hospital, Kanagawa (Japan)
11. Keijinkai Hospital, Sapporo (Japan)
12. Sapporo Medical University, Sapporo (Japan)
13. Institute of Biomedical Research and Innovation, Kobe (Japan)
14. School of Cancer Institute Ariake Hospital, Tokyo (Japan)
15. Kitami Red Cross Hospital, Kitami (Japan)
16. National Institute of Radiological Science, Chiba (Japan)
17. National Cancer Center, Tokyo (Japan)

Purpose: To review treatment outcomes for stereotactic body radiotherapy (SBRT) in medically operable patients with Stage I non-small-cell lung cancer (NSCLC), using a Japanese multi-institutional database. Patients and Methods: Between 1995 and 2004, a total of 87 patients with Stage I NSCLC (median age, 74 years; T1N0M0, n = 65; T2N0M0, n = 22) who were medically operable but refused surgery were treated using SBRT alone in 14 institutions. Stereotactic three-dimensional treatment was performed using noncoplanar dynamic arcs or multiple static ports. Total dose was 45-72.5 Gy at the isocenter, administered in 3-10 fractions. Median calculated biological effective dose was 116 Gy (range, 100-141 Gy). Data were collected and analyzed retrospectively. Results: During follow-up (median, 55 months), cumulative local control rates for T1 and T2 tumors at 5 years after SBRT were 92% and 73%, respectively. Pulmonary complications above Grade 2 arose in 1 patient (1.1%). Five-year overall survival rates for Stage IA and IB subgroups were 72% and 62%, respectively. One patient who developed local recurrences safely underwent salvage surgery. Conclusion: Stereotactic body radiotherapy is safe and promising as a radical treatment for operable Stage I NSCLC. The survival rate for SBRT is potentially comparable to that for surgery.

• OSTI ID: 22054487
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 5 Vol. 81; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
GY RANGE 10-100
GY RANGE 100-1000
LUNGS
NEOPLASMS
PATIENTS
RADIATION DOSES
RADIOTHERAPY
SURGERY