Early-Stage Non-Small Cell Lung Cancer Stereotactic Body Radiation Therapy Outcomes in a Single Institution

Doupnik, Nathan P; Hirmiz, Khalid; Hussein, Abdulkadir; Agapito, John; Pan, Ming

doi:10.7759/cureus.21878

Cited by 3 publications

(11 citation statements)

References 29 publications

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“…It is also a relatively simple and less time-consuming treatment modality for most patients because of the relatively low number of treatments. For inoperable early-stage non-small cell lung cancer, this technique can achieve a local control rate of 90% with stereotactic radiation therapy, a three-year survival rate of roughly 43%-83% and a five-year survival rate of 50%, and a two-year local control rate of roughly 70%-90% with stereotactic radiation therapy for brain metastases, with an overall survival rate of 40%-66% [9,10,11]. Because of the relatively high survival rate, it can be said that this is a very effective treatment modality and one that many doctors and patients are willing to choose.…”

Section: Clinical Results Of Sbrt In Brain Metastasesmentioning

confidence: 99%

Stereotactic body radiation therapy in brain metastases in the elderly population

Lyu

2023

Second International Conference on Biological Engineering and Medical Science (ICBioMed 2022)

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Brain metastases are a common tumour disease, and many cancer patients are prone to developing brain metastases after developing lung, breast and bowel cancer. However, not all parts of cancer can be completely removed, so in most cases, chemotherapy and radiotherapy are required to achieve a cure and prolong life. Stereotactic Body Radiation Therapy is a new radiation therapy technique that has emerged recently. The difference between this technique and conventional radiation therapy is that it requires a relatively high single dose, a higher degree of precision in localisation and better treatment results. When faced with the same treatment as the general population, the elderly are less tolerant of the drugs and radiation, and they are less able to repair the damage caused by the drugs and radiation, which makes it easier for them to die during the treatment process. This is why there are high demands on organ protection, the precision of positioning and dose to the target area in the elderly population when it comes to radiation therapy. This paper presents a short summary of Stereotactic Body Radiation Therapy for the elderly after diagnosis of brain metastases, including clinical response, side effects and organ protection in the elderly. Many of the paper's case data sources and clinical accounts are based on specific facts. To conclude, treating brain metastases is a very long process, and there is not enough time for elderly patients, and the SBRT technique can reduce the treatment time for patients.

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Section: Clinical Results Of Sbrt In Brain Metastasesmentioning

confidence: 99%

Stereotactic body radiation therapy in brain metastases in the elderly population

Lyu

2023

Second International Conference on Biological Engineering and Medical Science (ICBioMed 2022)

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“…For medically inoperable patients or those who refused surgery, it makes more sense to offer them SBRT since its use for early-stage primary NSCLC reported excellent LC [ 7 ]. Agolli et al reported its safety with no grade ≥3 toxicities recorded in the univariate analysis, but long-term LC and OS were much lower than the surgical series [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

“…His case was discussed in our tumor board meeting. The consensus was to treat this lesion with SBRT, using the same protocol for stage I non-small cell lung cancer (NSCLC), or OM [ 7 ]. He accepted high-dose SBRT at 48 Gy in four fractions every other day in February 2018 (Figure 2 ), prescribed to the planning target volume (PTV), with 100% of the dose covering 95% of the PTV and 100% of the gross tumor volume (GTV).…”

Section: Case Presentationmentioning

confidence: 99%

Metastasectomy and Stereotactic Body Radiotherapy for Colorectal Cancer With Liver and Lung Oligometastases: A Case Report of Complete Remission in a 96-Year-Old Patient

Pan

2024

Cureus

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We report a rare case of an extremely old colorectal cancer (CRC) patient who had complete remission after liver metastasectomy and stereotactic body radiotherapy (SBRT) to lung oligometastases (OM), with good quality of life and no evidence of recurrence 12 years after the initial diagnosis. An 83-year-old male patient had a right hemicolectomy for stage pT3 pN0 adenocarcinoma of the colon. Soon he was found to have liver metastasis treated with radiofrequency ablation and then liver metastasectomy with clear margins, followed by chemotherapy in the form of FOLFIRI for six months. Six years later, positron emission tomography (PET) showed 1.6 cm OM in the left upper lobe lung. He was not considered a good candidate for surgery. We offered him SBRT 48 Gy in four fractions every other day. The lesion disappeared with no recurrence in the same location on PET and serial computed tomography (CT) scans. Three years later, PET-CT found a new OM in the left lingular lung measuring 1.2 cm. A CT-guided lung biopsy confirmed invasive adenocarcinoma favoring OM from the CRC. SBRT planning failed due to its proximity to the heart. He accepted the longer course of conventional volumetric modulated arc therapy at 60 Gy in 15 fractions with daily cone-beam CT guidance. Again, he tolerated treatment very well with no significant side effects, despite his age. He did not require any chemotherapy or other systemic treatment in the last 11 years, so he did not experience any toxicities related to such treatment. This case is important to show that old age alone should not be considered a contraindication for metastasectomy and SBRT for CRC with liver and lung OM.

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“… 27 Latest report from Canadian researchers, who compared 4 different treatment groups (SBRT, hypofractionation, conventional and palliative irradiation) demonstrated that SBRT offered the best local control (94% at 3-years). 28 …”

Section: Discussionmentioning

confidence: 99%

“…In already mentioned studies other researchers report 1-year OS of 92%, 2-year 89% and 3-year 67%. 25 , 27 , 28 …”

Section: Discussionmentioning

confidence: 99%

Local control and survival after stereotactic body radiation therapy of early-stage lung cancer patients in Slovenia

Stanic,

But-Hadzic,

Zagar

et al. 2023

Radiology and Oncology

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Background Stereotactic body radiation therapy (SBRT) precisely and non-invasively delivers ablative radiation dose to tumors in early-stage lung cancer patients who are not candidates for surgery or refuse it. The aim of research was to evaluate local control, overall survival (OS), local progression free survival (LPFS), distant metastases free survival (DMFS), disease free survival (DFS) and toxicity in early-stage lung cancer patients treated with SBRT in a single tertiary cancer centre. Patients and methods We retrospectively evaluated medical records and radiation treatment plan parameters of 228 tumors irradiated in 206 early-stage lung cancer patients between 2016 and 2021 at the Institute of Oncology Ljubljana. Results After 25 months of median follow up, 68 of 206 (33%) patients died. Median OS was 46 months (CI 36–56), 1-year, 2-year and 3-year OS were 87%, 74% and 62% and 5-year OS was 31%. A total of 45 disease progressions have been identified in 41 patients. Local progress only was noticed in 5 (2%) patients, systemic progress in 32 (16%) and combined systemic and local in 4 (2%) patients. Local control rate (LCR) at 1 year was 98%, at 2 and 3 years 96% and 95% at 5 years. The 1-, 2- and 3-year LPFS were 98%, 96% and 94%, respectively and 5-year LPFS was 82%. One, 2-, 3- and 5-year DFS were 89%, 81%, 72% and 49%, respectively. Among 28 toxicities recorded only one was Grade 4 (pneumonitis), all others were Grade 1 or 2. No differences in LCR, LPFS, DFS were found in univariate analysis comparing patient, tumor, and treatment characteristics. For OS the only statistically significant difference was found in patients with more than 3 comorbidities compared to those with less comorbidities. Conclusions Early lung cancer treated with SBRT at single tertiary cancer centre showed that LCR, LPFS, DFS, DMFS and OS were comparable to published studies. Patients with many comorbidities had significantly worse overall survival compared to those with less comorbidities. No other significant differences by patient, tumor, or treatment characteristics were found for DMFS, LPFS, and DFS. Toxicity data confirmed that treatment was well tolerated.

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Early-Stage Non-Small Cell Lung Cancer Stereotactic Body Radiation Therapy Outcomes in a Single Institution

Cited by 3 publications

References 29 publications

Stereotactic body radiation therapy in brain metastases in the elderly population

Stereotactic body radiation therapy in brain metastases in the elderly population

Metastasectomy and Stereotactic Body Radiotherapy for Colorectal Cancer With Liver and Lung Oligometastases: A Case Report of Complete Remission in a 96-Year-Old Patient

Local control and survival after stereotactic body radiation therapy of early-stage lung cancer patients in Slovenia

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