Histology, Tumor Volume, and Radiation Dose Predict Outcomes in NSCLC Patients After Stereotactic Ablative Radiotherapy

Shiue, Kevin; Cerra-Franco, A.; Shapiro, Rachel; Estabrook, Neil C.; Mannina, Edward M.; Deig, Christopher R.; Althouse, Sandra K.; Liu, Sheng; Wan, Jun; Zang, Yong; Agrawal, Namita; Ioannides, P.J.; Liu, Yongmei; Zhang, Chen; DesRosiers, Colleen; Bartlett, G.; Ewing, M. R.; Langer, Márk; Watson, Gordon A.; Zellars, Richard C.; Kong, Feng-Ming; Lautenschlaeger, Tim

doi:10.1016/j.jtho.2018.06.007

Cited by 37 publications

(28 citation statements)

References 30 publications

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“…Regarding the former, we posit that our high institutional prescription doses (with median BED 10 of 112.5 Gy for the study population) may mitigate the adverse prognostic effect of squamous cell carcinoma histology. 39 This hypothesis is corroborated by prior studies by Hörner-Rieber et al 40 and Woody et al 41 both of which evaluated escalating prescription doses. As for the latter, we did find pre-SABR SUV max to be significantly associated with distant failure (similar to a previous report 38 ), although it was not identified as a predictor for TTP in general.…”

Section: Discussionsupporting

confidence: 58%

Predicting 5-Year Progression and Survival Outcomes for Early Stage Non-small Cell Lung Cancer Treated with Stereotactic Ablative Radiation Therapy: Development and Validation of Robust Prognostic Nomograms

Kang

Ning

Feng

et al. 2020

International Journal of Radiation Oncology*Biology*Physics

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Purpose: Our purpose was to develop predictive nomograms for overall survival (OS), progression-free survival (PFS), and time-to-progression (TTP) at 5 years in patients with early-stage non-small cell lung cancer (ES-NSCLC) treated with stereotactic ablative radiation therapy (SABR). Methods and Materials: The study cohort included 714 ES-NSCLC patients treated with SABR from 2004-2015 with median follow-up of 59 months, divided into training and testing sets (8:2), with the former used for nomogram development.

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Section: Discussionsupporting

confidence: 58%

Predicting 5-Year Progression and Survival Outcomes for Early Stage Non-small Cell Lung Cancer Treated with Stereotactic Ablative Radiation Therapy: Development and Validation of Robust Prognostic Nomograms

Kang

Ning

Feng

et al. 2020

International Journal of Radiation Oncology*Biology*Physics

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“…Patients were excluded if they had evidence of systemic spread of lung cancer at the time of SBRT. Radiation planning and treatment details have been previously reported [15]. Prescriptions typically were to the 80% isodose line, and the prescription typically covered at least 95% of the PTV.…”

Section: Study Populationmentioning

confidence: 99%

Predictors of Nodal and Metastatic Failure in Early Stage Non–small-cell Lung Cancer After Stereotactic Body Radiation Therapy

Cerra-Franco

Liu²,

Azar

et al. 2019

Clinical Lung Cancer

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Many ES-NSCLC patients develop metastases after SBRT. We retrospectively analyzed multiple variables in 406 lesions to develop a predictor for metastatic failure. GTV volume and prescription dose were significantly associated with metastases. A metastasis risk score tool was developed to identify patients at higher risk for metastases after lung SBRT who might benefit from enrollment in future trials evaluating the benefit of adjuvant or intensified treatment.

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“…Prior studies have shown that SBRT may be associated with unacceptable toxicity for tumors greater than 5 cm [2], [3]. Also, large tumors may be near surrounding OARs, which can make planning difficult [4], [5].…”

Section: Introductionmentioning

confidence: 99%

Spatially fractionated stereotactic body radiotherapy (Lattice SBRT) for large tumors

Duriseti

Kavanaugh

Goddu

et al. 2020

Preprint

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Stereotactic body radiotherapy (SBRT) has demonstrated clinical benefit for patients with metastatic and/or unresectable cancer. Technical considerations of treatment delivery and sensitive organs at risk (OARs) limit the use of SBRT in large tumors or those in unfavorable locations. Spatially fractionated radiotherapy (SFRT) delivers high-dose radiation to discrete sub-volume vertices within a tumor target while restricting the remainder of the target to low dose. SFRT has been utilized for treatment of large tumors with reported dramatic tumor response and minimal side effects. Lattice is a modern approach to SFRT that can be delivered with arc-based therapy, which allows for the rapid dose fall-off required for high quality SBRT. In order to overcome the limitations of SBRT for large tumors, we developed Lattice SBRT. Here we report the results of a dosimetry and quality assurance (QA) feasibility study of Lattice SBRT in 11 patients with 12 tumor targets, each ≥ 10 cm in an axial dimension. Prior CT simulation scans were used to generate volumetric-modulated arc therapy (VMAT) Lattice SBRT plans that were then delivered on clinically available Linacs. QA testing included external portal imaging device (EPID) and ion chamber (IC) analysis. All generated plans were able to meet the standard SBRT dose constraints, such as those from AAPM Task Group 101. Additionally, we provide a step-by-step approach for generating and delivering Lattice SBRT plans using commercially available treatment technology. Lattice SBRT is currently being tested in a prospective trial for patients with metastatic cancer needing palliation of a large tumor (NCT04133415).

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Histology, Tumor Volume, and Radiation Dose Predict Outcomes in NSCLC Patients After Stereotactic Ablative Radiotherapy

Cited by 37 publications

References 30 publications

Predicting 5-Year Progression and Survival Outcomes for Early Stage Non-small Cell Lung Cancer Treated with Stereotactic Ablative Radiation Therapy: Development and Validation of Robust Prognostic Nomograms

Predicting 5-Year Progression and Survival Outcomes for Early Stage Non-small Cell Lung Cancer Treated with Stereotactic Ablative Radiation Therapy: Development and Validation of Robust Prognostic Nomograms

Predictors of Nodal and Metastatic Failure in Early Stage Non–small-cell Lung Cancer After Stereotactic Body Radiation Therapy

Spatially fractionated stereotactic body radiotherapy (Lattice SBRT) for large tumors

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