Local control dependence on consecutive vs. nonconsecutive fractionation in lung stereotactic body radiation therapy

Alite, Fiori; Stang, K.; Balasubramanian, Neelam; Adams, William; Shaikh, M.P.; Small, Christina; Sethi, Anil; Nagda, S.; Emami, Bahman; Harkenrider, Matthew M.

doi:10.1016/j.radonc.2016.07.026

Cited by 30 publications

(21 citation statements)

References 35 publications

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“…For example, treatment on nonconsecutive days, rather than daily, is potentially beneficial in reducing toxicity (61,62). Whether non-consecutive fractionation results in improved disease control needs further evaluation (63). Technological advances in the form of proton or carbon ion therapy may be beneficial in the treatment of higher risk patients, such as those with cardiopulmonary comorbidities or prior thoracic irradiation, for whom maximal dose conformity is warranted to prevent excess toxicity (102,106).…”

Section: Discussionmentioning

confidence: 99%

Stereotactic body radiation therapy (SBRT) for early stage non-small cell lung cancer (NSCLC): contemporary insights and advances

Sebastian¹,

Xu‐Welliver²,

Williams³

2018

J. Thorac. Dis.

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The standard-of-care treatment for early-stage non-small cell lung cancer (NSCLC) continues to be surgery in the form of lobectomy or pneumonectomy. Stereotactic body radiation therapy (SBRT) has evolved as a viable alternative to surgery for medically inoperable patients, achieving excellent local control (LC) with relatively minimal toxicity in standard-risk patients. Nevertheless, the maturation of SBRT has fostered debate regarding its use, technique, dose, and fractionation, particularly in the context of patient- and disease-specific characteristics such as tumor size and location. This review will cover the recent trends and future directions of SBRT as it becomes an increasingly individualized modality in the treatment of early-stage NSCLC.

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Section: Discussionmentioning

confidence: 99%

Stereotactic body radiation therapy (SBRT) for early stage non-small cell lung cancer (NSCLC): contemporary insights and advances

Sebastian¹,

Xu‐Welliver²,

Williams³

2018

J. Thorac. Dis.

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“… 11 In medically frail patients, separation of the treatments from daily to non-daily schedules may be advantageous, as it allows time for rest and recovery between each treatment, and may be supported by clinical evidence of superior outcomes. 12 …”

Section: Qol In Patients Treated With Sbrtmentioning

confidence: 99%

Stereotactic body radiation therapy (SBRT) in the management of non-small-cell lung cancer: Clinical impact and patient perspectives

Donovan

Swaminath

2018

LCTT

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Stereotactic body radiation therapy (SBRT) has emerged as a new technology in radiotherapy delivery, allowing for potentially curative treatment in many patients previously felt not to be candidates for radical surgical resection of stage I non-small-cell lung cancer (NSCLC). Several studies have demonstrated very high local control rates using SBRT, and more recent data have suggested overall survival may approach that of surgery in operable patients. However, SBRT is not without unique toxicities, and the balance of toxicity, and effect on patient-reported quality of life need to be considered with respect to oncologic outcomes. We therefore aim to review SBRT in the context of important patient-related factors, including quality of life in several domains (and in comparison to other therapies such as conventional radiation, surgery, or no treatment). We will also describe scenarios in which SBRT may be reasonably offered (i.e. elderly patients and those with severe COPD), and where it may need to be approached with some caution due to increased risks of toxicity (i.e. tumor location, patients with interstitial lung disease). In total, we hope to characterize the physical, emotional, and functional consequences of SBRT, in relation to other management strategies, in order to aid the clinician in deciding whether SBRT is the optimal treatment choice for each patient with early stage NSCLC.

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“…However, it is noteworthy that whether the tumor size really matters is controversial nowadays. Some studies reported that tumor stage had statistically significant effect on LC for NSCLC patients undergoing SBRT [11, 14]; however, the point of view has been challenged by other investigations which showed that LC was not associated with tumor stage [32–34]. The contradiction is mainly induced by the employment of the risk-adapted prescribed dose fractionation based on tumor size in Baba and Allibhai's study [33, 34].…”

Section: Discussionmentioning

confidence: 99%

Comparative Analysis of Local Control Prediction Using Different Biophysical Models for Non-Small Cell Lung Cancer Patients Undergoing Stereotactic Body Radiotherapy

Huang

Zhang

et al. 2017

BioMed Research International

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Purpose The consistency for predicting local control (LC) data using biophysical models for stereotactic body radiotherapy (SBRT) treatment of lung cancer is unclear. This study aims to compare the results calculated from different models using the treatment planning data. Materials and Methods Treatment plans were designed for 17 patients diagnosed with primary non-small cell lung cancer (NSCLC) using 5 different fraction schemes. The Martel model, Ohri model, and the Tai model were used to predict the 2-year LC value. The Gucken model, Santiago model, and the Tai model were employed to estimate the 3-year LC data. Results We found that the employed models resulted in completely different LC prediction except for the Gucken and the Santiago models which exhibited quite similar 3-year LC data. The predicted 2-year and 3-year LC values in different models were not only associated with the dose normalization but also associated with the employed fraction schemes. The greatest difference predicted by different models was up to 15.0%. Conclusions Our results show that different biophysical models influence the LC prediction and the difference is not only correlated to the dose normalization but also correlated to the employed fraction schemes.

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Local control dependence on consecutive vs. nonconsecutive fractionation in lung stereotactic body radiation therapy

Cited by 30 publications

References 35 publications

Stereotactic body radiation therapy (SBRT) for early stage non-small cell lung cancer (NSCLC): contemporary insights and advances

Stereotactic body radiation therapy (SBRT) for early stage non-small cell lung cancer (NSCLC): contemporary insights and advances

Stereotactic body radiation therapy (SBRT) in the management of non-small-cell lung cancer: Clinical impact and patient perspectives

Comparative Analysis of Local Control Prediction Using Different Biophysical Models for Non-Small Cell Lung Cancer Patients Undergoing Stereotactic Body Radiotherapy

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