Results of a Phase I Dose Escalation Study Using Single Fraction Stereotactic Radiosurgery (SFSR) for Lung Tumors

Stereotactic radiosurgery for the treatment of stage I non–small cell lung cancer in high-risk patients

“…8 Because the results of conventional external beam radiation are suboptimal, novel treatment approaches such as SRS and radiofrequency ablation (RFA) may be applicable in this high-risk group of patients. [11][12][13][14][15][16][17] The results of SRS for the treatment of stage I NSCLC in our study compare favorably with the previously mentioned studies in which conventional radiotherapy was used. The assessment of response is challenging after ablative therapies such as SRS and radiofrequency ablation (RFA), because many treated patients have residual scarring.…”

“…Le and colleagues 14 reported the results of a dose escalation study in patients with lung neoplasm with single-fraction treatment. There were 21 patients with stage I NSCLC and 11 with metastatic tumors.…”

“…The doses administered were less than 20 Gy in 10 patients, 25 Gy in 20, and 30 Gy in 2. At a median follow-up of 18 months, Le and colleagues 14 reported a 1-year survival of 85% for patients with stage I NSCLC. The 1-year freedom from local progression was 91% for patients who received a dose greater than 20 Gy, versus 54% for those who received less than 20 Gy.…”

“…Our current approach is to treat only peripheral lesions with a higher dose of 60 Gy in 3 fractions to balance the toxic effects with local control. Further, as highlighted by Le and colleagues, 14 caution should be exercised, particularly with gemcitabine-based adjuvant therapy, when a large single fraction dose is used.…”

“…10 There have been few reports from the United States of application of SRS to the treatment of lung malignancies This modality of treatment is evolving. [11][12][13][14][15] We have previously reported on our experience with SRS in patients with primary and metastatic lung neoplasms. 15 In this article, we present our preliminary results with the use of SRS for the treatment of stage I NSCLC in medically inoperable patients.…”