Influence of patient characteristics on survival following treatment with helical stereotactic body radiotherapy (SBRT) in stage I non‐small‐cell lung cancer

Abstract

Background: To determine the influence of patient and tumor characteristics on clinical outcomes in patients with early-stage non-small cell lung cancer (NSCLC) treated with helical intensity modulated stereotactic body radiotherapy (SBRT). Methods: From March 2005 to August 2010 a total of 62 patients with biopsy proven Stage I NSCLC underwent helical SBRT with 48 Gy in 4 fractions or 60 Gy in 5 fractions. Patient and tumor characteristics including tumor stage, age, sex, tumor histology, maximal tumor diameter, and smoking history, were evaluated in regard to local control and overall survival using Kaplan-Meier survival curves and the Cox proportional hazard method. Treatment related toxicity in the patient subgroups was evaluated. Results: The median follow-up was 28 months. Total cohort local control was 93.55% and 3-year overall survival (OS) was 53.4%. Those patients with Stage IA disease had a 3-year OS of 64.4% versus 32.1% for Stage IB disease (P = 0.042). Tumors classified as T1a (Յ20 mm) and T1b (20-30 mm) had significantly increased overall survival compared to T2 (>30 mm) tumors (P = 0.046). There was a slight survival advantage in those patients with adenocarcinoma. No correlation between age, gender or smoking history, and overall survival was found. Nine patients had radiation related toxicity, which was increasingly more common with advancing age. Conclusion: Helical SBRT is an effective method to treat NSCLC and the most significant prognostic factors were tumor stage and size. There was no correlation between age, gender, and smoking history.

Survival After Stereotactic Body Radiation Therapy for Clinically Diagnosed or Biopsy-Proven Early-Stage NSCLC: A Systematic Review and Meta-Analysis

“…The pooled estimate for 5-year OS for biopsy-proven disease (n ¼ 8101) was not significantly different 17,19,25,27,28,[32][33][34][35]38,39,41,42,[44][45][46][48][49][50]52,53,55,59 respectively (Fig 3). For 3-year OS, there was no difference between clinical disease 19 21,26,30,31,36,40,46,49,51,54,56,58,59 for biopsy-proven disease (n ¼ 998 and n ¼7249), respectively.…”

Comparison of Stereotactic Body Radiation Therapy for Biopsy-Proven versus Radiographically Diagnosed Early-Stage Non-Small Lung Cancer: A Single-Institution Experience

“…The treatment planning and delivery process was previously described (12). Briefly, the process included a TomoTherapy Hi-Art (TomoTherapy, Madison, Wl, USA) linear accelerator, a 16-slice CT simulator with 4-dimensional capability (Philips, Milipitas, CA, USA), the Pinnacle (Pinnacle v8.0m; Philips, Milipitas, CA, USA) treatment planning contouring station, and the TomoTherapy IMRT planning unit.…”

“…Therapeutic efficacy was evaluated using the modified Response Evaluation Criteria in Solid Tumors (RECIST) (14) and as previously described (12). Complete response was defined as complete disappearance of tumor or complete loss of metabolic activity as measured by PET/CT.…”

<p>Prognostic Role Of Computed Tomography Textural Features In Early-Stage Non-Small Cell Lung Cancer Patients Receiving Stereotactic Body Radiotherapy</p>

“…For instance, continued smoking decreased the overall survival (OS) of NSCLC patients who received combined chemotherapy and radiation therapy 27. However, smoking was not considered to correlate with clinical endpoints in other studies 28,29. Moreover, even for the SUVmax from PET/CT images acquired prior to SBRT, the debate is ongoing, and results have been inconclusive 30–32.…”