Stereotactic ablative radiotherapy for operable stage I non-small-cell lung cancer (revised STARS): long-term results of a single-arm, prospective trial with prespecified comparison to surgery

Chang, Joe Y.; Mehran, Reza J.; Feng, Lei; Verma, Vivek; Liao, Zhongxing; Welsh, James W.; Lin, Steven H.; O’Reilly, Michael S.; Jeter, Melenda; Balter, Peter A; McRae, Stephen E.; Berry, Donald A.; Heymach, John V.; Roth, Jack A.; Antonoff, Mara B.; Hofstetter, Wayne; Rajaram, Ravi; Rice, David C.; Sepesi, Boris; Swisher, Stephen G.; Vaporciyan, Ara A.; Walsh, Garrett L.; DeGraaf, Craig; Correa, Arlene M.; Chen, Aileen B.; Gandhi, Saumil; Komaki, Ritsuko; Lee, Percy; Nguyen, Quynh‐Nhu; Ning, Matthew S.; Gao, Song; Pollard‐Larkin, Julianne; Nitsch, Paige L.; Sadagopan, R; Wang, Xiaochun

doi:10.1016/s1470-2045(21)00401-0

Cited by 169 publications

(100 citation statements)

References 29 publications

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“…In this context, several publications already showed comparable outcomes in patients after empiric SBRT, supporting the hypothesis that patients did have lung cancers(16-18). Loco-regional control was good and comparable to other studies of lung SBRT and also in compare to surgical outcomes after video-assisted thoracoscopic surgical lobectomy with mediastinal lymph node dissection (19).…”

Section: Toxicitysupporting

confidence: 80%

Lung Stereotactic Radiation Therapy: Intercomparison of Several Irradiation Devices in Terms of Outcome and Predictive Factors

Reun

Casutt

Durham

et al. 2022

Preprint

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Background: Stereotactic body radiotherapy (SBRT) is recommended for the treatment of inoperable early stage non-small-cell lung cancer and lung oligometastases. The radiation oncology department of the Lausanne University Hospital (CHUV) gathers three different radiotherapy devices able to treat pulmonary lesions in SBRT conditions: CyberKnife® (CK), Helical Tomotherapy® (HT), and volumetric modulated arc therapy (VMAT). The aim of this study is to define the patients’ outcome in terms of irradiation efficacy and toxicities after lung SBRT depending of the choice of the SBRT technique.Methods: We retrospectively analyzed the clinical, radiological, and dosimetric data of patients with primary lung tumor or pulmonary oligometastases treated with SBRT between January 2016 and February 2020. We analyzed descriptive data using the Chi-2 test for proportions and the T-test for means comparisons, survival data by the Kaplan-Meier method and comparisons between groups by the Log-rank test and Cox-regression.Results: We identified 111 patients mostly in good condition (82.9% PS 0-1) with a median age of 71.4 years. One hundred forty-two lesions were treated with a typical fractionation of 55 Gy in 5 fractions, delivered by CK (59.9%), VMAT (38.0%), or HT (2.1%). Compared to other techniques, CK technique allowed to treat comparable gross tumor volume (GTV; 2.1 vs 1.4cc, p = 0.84) with smaller planning treatment volume (PTV; 12.3 vs 21.9 cc, p = 0.013), and was associated with a lower mean lung dose (MLD; 2.6 vs 4.1 Gy, p < 0.001), a lower V5 (13.5 vs 19.9 cc, p = 0.002) and a lower V20 (2.3 vs 5.4 cc, p < 0.001). Local control rates at 2 years were not different depending on the irradiation device, respectively of 96.2% (range, 90.8-100) and 98.1% (range, 94.4-100), p = 0.68. Toxicity incidence was significantly increased with V5 value > 17.2% (56.0 vs 77.4%, p = 0.021). Conclusions: Compared to other SBRT techniques, CK treatments permitted to treat comparable GTV with reduced PTV, MLD, V20, and V5. The dosimetric benefit of CK SBRT was not associated with a clear clinical benefit, with comparable outcome in terms of control rates and toxicity. Toxicity incidence was less frequent when reducing the V5. The use of CK is particularly attractive in case of multiple courses of lung SBRT or in case of local relapse requiring lung re-irradiation.Trial registration: Registered on February 24th 2021, ID 2021-00267, with the authorization of the CER-VD ethics committee (Switzerland).

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Section: Toxicitysupporting

confidence: 80%

Lung Stereotactic Radiation Therapy: Intercomparison of Several Irradiation Devices in Terms of Outcome and Predictive Factors

Reun

Casutt

Durham

et al. 2022

Preprint

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“…The radiation dose was 54 Gy delivered in three fractions (for peripheral tumors) or 50 Gy in four fractions (for central tumors, with simultaneous integrated boost to the gross tumor totaling 60 Gy). The 3-year overall survival and severe toxicity rates of the 80 patients after SABR were 91% and 1%, respectively, which were non-inferior to the rates obtained with surgery ( 15 ).…”

Section: Discussionmentioning

confidence: 61%

Bibliometric Analysis of the Top-Cited Publications and Research Trends for Stereotactic Body Radiotherapy

Liu

et al. 2021

Front. Oncol.

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ObjectiveThis study aims to analyze the 100 most cited papers and research trends on stereotactic body radiotherapy (SBRT).MethodsWe used Web of Science to identify the 100 most frequently cited papers on SBRT on September 29, 2021 and extracted the following data: publication year, source title, country/region, organization, total citations, and average number of citations per year. The research type and research domain were classified independently by the authors. Then we carried out a bibliometric analysis to determine the trends in research on SBRT.ResultsThese 100 papers were cited a total of 26,540 times, and the median number of citations was 190 (range, 138-1688). “Stereotactic body radiation therapy for inoperable early stage lung cancer” by Timmerman et al. had the highest number of total citations (1688 times). International Journal of Radiation Oncology, Biology, Physics published the largest number of papers (37 papers), followed by Journal of Clinical Oncology (13 papers). The USA contributed the most papers (67 papers), followed by Canada (18 papers). Primary lung cancer (33 papers, 10,683 citations) and oligometastases (30 papers, 7,147 citations) were the most cited research areas.ConclusionsTo the best of our knowledge, this is the first bibliometric analysis of the most frequently cited papers on SBRT. Our results provide insight into the historical development of SBRT and important advances in its application to cancer treatment. Early-stage non–small-cell lung cancer and oligometastases were the most cited research areas in the top 100 publications on SBRT, and SBRT combined with immunotherapy was a hot topic in the past few years. This study is helpful for researchers to identify the most influential papers and current research hotspots on SBRT.

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“…However, the risk score did not distinguish between the risk in stage IIIB and stage IV. It should be noted that stage IA lung cancer is usually treated only by surgery ( Chang et al, 2021 ), indicating that patients with high GARS IA LUAD need further treatment.…”

Section: Discussionmentioning

confidence: 99%

Prognosis and Immunotherapy Response With a Novel Golgi Apparatus Signature-Based Formula in Lung Adenocarcinoma

Jiang

Ouyang

Zhang

et al. 2022

Front. Cell Dev. Biol.

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The Golgi apparatus (GA) is a cellular organelle that participates in the packaging, modification, and transport of proteins and lipids from the endoplasmic reticulum to be further fabricated before being presented to other cellular components. Recent studies have demonstrated that GA facilitates numerous cellular processes in cancer development. Therefore, this study aimed to establish a novel lung adenocarcinoma (LUAD) risk evaluation model based on GA gene signatures. In this study, we used TCGA-LUAD (n = 500) as the training cohort and GSE50081 (n = 127), GSE68465 (442), and GSE72094 (398) as the validation cohorts. Two immunotherapy datasets (GSE135222 and GSE126044) were also obtained from a previous study. Based on machine algorithms and bioinformatics methods, a GA gene-related risk score (GARS) was established. We found that the GARS independently predicted the prognosis of LUAD patients and remained effective across stages IA to IIIA. Then, we identified that the GARS was highly correlated with mutations in P53 and TTN. Further, this study identified that GARS is related to multiple immune microenvironmental characteristics. Furthermore, we investigated GSE135222 and GSE126044 and found that a lower GARS may be indicative of an improved therapeutic effect of PD-1/PD-L1 therapy. We also found that high GARS may lead to a better response to multiple anticancer drugs. Finally, we established a nomogram to better guide clinical application. To our knowledge, this is the first study to demonstrate a novel GA signature-based risk score formula to predict clinical prognosis and guide the treatment of LUAD patients.

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Stereotactic ablative radiotherapy for operable stage I non-small-cell lung cancer (revised STARS): long-term results of a single-arm, prospective trial with prespecified comparison to surgery

Cited by 169 publications

References 29 publications

Lung Stereotactic Radiation Therapy: Intercomparison of Several Irradiation Devices in Terms of Outcome and Predictive Factors

Lung Stereotactic Radiation Therapy: Intercomparison of Several Irradiation Devices in Terms of Outcome and Predictive Factors

Bibliometric Analysis of the Top-Cited Publications and Research Trends for Stereotactic Body Radiotherapy

Prognosis and Immunotherapy Response With a Novel Golgi Apparatus Signature-Based Formula in Lung Adenocarcinoma

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