Progression of Non–Small-Cell Lung Cancer During the Interval Before Stereotactic Body Radiotherapy

Murai, Taro; Shibamoto, Yuta; Baba, F.; Hashizume, Chisa; Mori, Yoshimasa; Ayakawa, S.; Kawai, Tatsuya; Takemoto, Shinya; Sugie, Chikao; Ogino, Hiroyuki

doi:10.1016/j.ijrobp.2010.10.001

Cited by 37 publications

(21 citation statements)

References 20 publications

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“…Amongst all models considered, the regrowth model fits the data with the lowest χ 2 /ndf and can provide extra information on the potential tumor doubling time (47±16 and 95±31 days for the T1 and T2 tumors, respectively, and 64±6 days regardless of tumor stages), consistent with those in Ref. (67). The T1 tumors grow much faster than the T2 tumors.…”

Section: Discussionsupporting

confidence: 82%

Tumor control probability modeling for stereotactic body radiation therapy of early-stage lung cancer using multiple bio-physical models

Liu

Tai

Lee

et al. 2017

Radiotherapy and Oncology

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Purpose To analyze pooled clinical data using different radiobiological models and to understand the relationship between biologically effective dose (BED) and tumor control probability (TCP) for stereotactic body radiotherapy (SBRT) of early-stage non-small cell lung cancer (NSCLC). Method and Materials The clinical data of 1-, 2-, 3-, and 5-year actuarial or Kaplan-Meier TCP from 46 selected studies were collected for SBRT of NSCLC in the literature. The TCP data were separated for Stage T1 and T2 tumors if possible, otherwise collected for combined stages. BED was calculated at isocenters using six radiobiological models. For each model, the independent model parameters were determined from a fit to the TCP data using the least chi-square (χ2) method with either one set of parameters regardless of tumor stages or two sets for T1 and T2 tumors separately. Results The fits to the clinic data yield consistent results of large α/β ratios of about 20 Gy for all models investigated. The regrowth model that accounts for the tumor repopulation and heterogeneity leads to a better fit to the data, compared to other 5 models where the fits were indistinguishable between the models. The models based on the fitting parameters predict that the T2 tumors require about additional 1 Gy physical dose at isocenters per fraction (≤5 fractions) to achieve the optimal TCP when compared to the T1 tumors. Conclusion This systematic analysis of a large set of published clinical data using different radiobiological models shows that local TCP for SBRT of early-stage NSCLC has strong dependence on BED with large α/β ratios of about 20 Gy. The six models predict that a BED (calculated with α/β of 20) of 90 Gy is sufficient to achieve TCP ≥ 95%. Among the models considered, the regrowth model leads to a better fit to the clinical data.

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Section: Discussionsupporting

confidence: 82%

Tumor control probability modeling for stereotactic body radiation therapy of early-stage lung cancer using multiple bio-physical models

Liu

Tai

Lee

et al. 2017

Radiotherapy and Oncology

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“…However, lung cancer rapidly leads to death even among clinical stage I patients. Murai et al [26] reported that the median volume doubling times of adenocarcinoma and squamous cell carcinoma of lung cancer were 170 and 93 days, respectively. They alerted that a waiting time to treatment of longer than 4 weeks seems generally undesirable.…”

Section: Discussionmentioning

confidence: 99%

Stereotactic body radiotherapy (SBRT) for solitary pulmonary nodules clinically diagnosed as lung cancer with no pathological confirmation: Comparison with non-small-cell lung cancer

et al. 2012

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“…start of RTP or CBCT, respectively), no T stage progression was found in 41 of the patients. However, this study did not differentiate “from diagnosis to simulation” and “from simulation to treatment” (the in‐between period in our study) . Salamekh et al evaluated the trend of tumor growth of 18 lung tumors from 15 cases.…”

Section: Discussionmentioning

confidence: 79%

What if a tumor is significantly enlarged just before stereotactic body radiation therapy? A case report and review of the literature

et al. 2016

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Stereotactic body radiation therapy (SBRT) plays an important role in early stage non‐small cell lung cancer. Tumor growth before radiotherapy planning (RTP) or during SBRT has been reported in lung cancer patients; however, little is known of growth during the period in‐between (i.e. after RTP but before SBRT). An 83‐year‐old man referred to our hospital and diagnosed with medically inoperable non‐small cell lung cancer was noted to have significant tumor progression on day 1 of cone beam computed tomography just before the planned SBRT delivery. Because of uncertainty of the underlying etiology and unfamiliarity with this phenomenon, we made a clinical decision to arrange re‐simulation and revise our treatment to conventional fractionated radiotherapy (CFRT). After an initial response, distant metastases occurred eight months after CFRT. The patient received best supportive care and was under hospice care at the last follow‐up (27 months after CFRT). We report a case with significant tumor growth just before planned SBRT. Optimal management in this scenario requires further investigation.

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Progression of Non–Small-Cell Lung Cancer During the Interval Before Stereotactic Body Radiotherapy

Cited by 37 publications

References 20 publications

Tumor control probability modeling for stereotactic body radiation therapy of early-stage lung cancer using multiple bio-physical models

Tumor control probability modeling for stereotactic body radiation therapy of early-stage lung cancer using multiple bio-physical models

Stereotactic body radiotherapy (SBRT) for solitary pulmonary nodules clinically diagnosed as lung cancer with no pathological confirmation: Comparison with non-small-cell lung cancer

What if a tumor is significantly enlarged just before stereotactic body radiation therapy? A case report and review of the literature

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