Stereotactic Body Radiotherapy (SBRT) with Lower Doses for Selected Patients with Stage I Non-small-cell Lung Cancer (NSCLC)

Kaesmann, Lukas; Rudat, Volker; Rades, Dirk

doi:10.1007/s00408-016-9849-4

Cited by 24 publications

(18 citation statements)

References 13 publications

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“…One phase 3 study comparing SBRT and surgery (only the SBRT data was used) [12], 10 phase 2 [20-31], 1 phase 1 [32], and 56 retrospective [33-51,53-89] photon SBRT studies were included in the survival outcome comparison analysis. Among them, treatment-related toxicities were reported in all the prospective studies [12,20-32], and 40 retrospective studies [34,37,39-40,42,44-47,49,52-61,65,67-73,76-78, 80-82,84-89]. These studies were included in the treatment-related toxicity comparison analysis.…”

Section: Resultsmentioning

confidence: 99%

Comparison of particle beam therapy and stereotactic body radiotherapy for early stage non-small cell lung cancer: A systematic review and hypothesis-generating meta-analysis

Chi¹,

Chen

Wen

et al. 2017

Radiotherapy and Oncology

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Purpose To assess hypo-fractionated particle beam therapy (PBT)'s efficacy relative to that of photon stereotactic body radiotherapy (SBRT) for early stage (ES) non-small cell lung cancer (NSCLC). Methods Eligible studies were identified through extensive searches of the PubMed, Medline, Google-scholar, and Cochrane library databases from 2000 to 2016. Original English publications of ES NSCLC were included. A meta-analysis was performed to compare the survival outcome, toxicity profile, and patterns of failure following each treatment. Results 72 SBRT studies and 9 hypo-fractionated PBT studies (mostly single-arm) were included. PBT was associated with improved overall survival (OS; p = 0.005) and progression-free survival (PFS; p = 0.01) in the univariate meta-analysis. The OS benefit did not reach its statistical significance after inclusion of operability into the final multivariate meta-analysis (p = 0.11); while the 3-year local control (LC) still favored PBT (p = 0.03). Conclusion Although hypo-fractionated PBT may lead to additional clinical benefit when compared with photon SBRT, no statistically significant survival benefit from PBT over SBRT was observed in the treatment of ES NSCLC in this hypothesis-generating meta-analysis after adjusting for potential confounding variables.

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Section: Resultsmentioning

confidence: 99%

Comparison of particle beam therapy and stereotactic body radiotherapy for early stage non-small cell lung cancer: A systematic review and hypothesis-generating meta-analysis

Chi¹,

Chen

Wen

et al. 2017

Radiotherapy and Oncology

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“…Conflicting data on the use of surveillance chest imaging stem from debate over detection of recurrence versus second primary lung cancer and synchronous versus metachronous primary lesions. The growing use of stereotactic body radiation therapy in the treatment of recurrence (34)(35)(36) and/or metachronous cancers (37) and second primary lung cancers (38) may help redefine the role of surveillance in patients with lung cancer.…”

Section: Original Researchmentioning

confidence: 99%

Pattern of Imaging after Lung Cancer Resection. 1992–2005

Sharma

Nishi²,

Lin

et al. 2016

Annals ATS

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Rationale: Imaging intensity after lung cancer resection performed with curative intent is unknown.Objectives: To describe the pattern and trends in the use of computed tomography (CT) and positron emission tomography (PET) scans in patients after resection of early-stage lung cancer. Measurements and Main Results: Overall, imaging use was higher within the first 2 years versus Years 3-5 after surgical resection. Use of surveillance CT scans increased sharply from 13.7 to 57.3% of those diagnosed in 1996-1997 and 2004-2005, respectively. PET scan use increased threefold, from 6.2% in 2000-2001 to 19.6% in 2004-2005. In multivariable analyses, we observed a 32% increase in the odds of undergoing surveillance CT or PET imaging for every year of diagnosis between 1998 and 2005. There was no substantial decline in the odds of having a surveillance CT or PET scan during each successive follow-up period, suggesting no change in the intensity of surveillance over the first 5 years after surgical resection. The proportion of surveillance CT imaging performed at freestanding imaging centers increased from 18.0% in 1998-1999 to 30.6% in 2004-2005. Methods Conclusions:The use of CT and PET imaging for surveillance after curative-intent surgical resection of early-stage lung cancer increased sharply in the United States between 1997-1998 and 2005. In the absence of evidence demonstrating favorable outcomes, this practice was likely driven by prevailing expert opinion embedded in clinical practice guidelines made available during that time. Research is clearly needed to determine the role and optimal approach to surveillance thoracic imaging after surgical resection of lung cancer.

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“…This report demonstrated the feasibiliy of SBRT to synchronous lung nodules. Furthermore, several studies have shown feasibility of lower dose SBRT for recurrent lung cancer, with local control rates of up to 96% at one year and freedom from distant progression rate at 74% at one year and 65% at two years …”

Section: Factors Favoring Sbrtmentioning

confidence: 99%

Which patients benefit most from stereotactic body radiotherapy or surgery in medically operable non‐small cell lung cancer? An in‐depth look at patient characteristics on both sides of the debate

Chua

2019

Thoracic Cancer

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The role of stereotactic body radiotherapy (SBRT) in early stage medically operable non‐small cell lung cancer is currently under debate. SBRT's advantage is its ability to provide high radiotherapy doses to a tumor in a short timeframe, without the risk of postoperative complications and mortality. Currently, in part due to limited prospective data comparing both treatments, international guidelines continue to recommend surgical resection as the gold standard for medically operable patients. However, not all patients possess uniform characteristics, and there is some evidence that certain subgroups of patients would benefit more from one form of treatment ‐ SBRT or surgery ‐ than the other. The aim of this review is to provide a brief summary of the evidence comparing SBRT to surgery, followed by a deeper discussion of the subgroups of patients who would benefit most from surgery: those with large tumors, centrally located tumors, increased risk of occult nodal metastases, increased risk of toxicity from radiotherapy and radioresistant histological tumor subtypes. Meanwhile, patients who could benefit most from SBRT might include elderly patients, those with reduced lung function or cardiac comorbidities, those with synchronous lung nodules, and those with specific tumor mutational status. We hope that this review will aid in the clinical decision‐making process regarding patient selection for either treatment.

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Stereotactic Body Radiotherapy (SBRT) with Lower Doses for Selected Patients with Stage I Non-small-cell Lung Cancer (NSCLC)

Cited by 24 publications

References 13 publications

Comparison of particle beam therapy and stereotactic body radiotherapy for early stage non-small cell lung cancer: A systematic review and hypothesis-generating meta-analysis

Comparison of particle beam therapy and stereotactic body radiotherapy for early stage non-small cell lung cancer: A systematic review and hypothesis-generating meta-analysis

Pattern of Imaging after Lung Cancer Resection. 1992–2005

Which patients benefit most from stereotactic body radiotherapy or surgery in medically operable non‐small cell lung cancer? An in‐depth look at patient characteristics on both sides of the debate

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