Surgical management of early stage lung cancer

Zorn, George L.; Nesbitt, Jonathan C.

doi:10.1002/(sici)1098-2388(200003)18:2<124::aid-ssu6>3.0.co;2-n

Cited by 16 publications

(4 citation statements)

References 92 publications

(88 reference statements)

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“…Surgical resection remains the standard management for patients with Stage I NSCLC. The 5‐year overall survival rates for patients undergoing resection range from 55% to 72% for Stage I NSCLC 15–17. Results for treating early‐stage NSCLC using conventional radiotherapy are disappointing.…”

Section: Discussionmentioning

confidence: 99%

Stereotactic hypofractionated high‐dose irradiation for stage I nonsmall cell lung carcinoma

Oda

Araki

Shirato³

et al. 2004

Cancer

816

438

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BACKGROUND Stereotactic irradiation (STI) has been actively performed using various methods to achieve better local control of Stage I nonsmall cell lung carcinoma (NSCLC) in Japan. The authors retrospectively evaluated results from a Japanese multiinstitutional study. METHODS Patients with Stage I NSCLC (n = 245; median age, 76 years; T1N0M0, n=155; T2N0M0, n=90) were treated with hypofractionated high‐dose STI in 13 institutions. Stereotactic three‐dimensional treatment was performed using noncoplanar dynamic arcs or multiple static ports. A total dose of 18–75 gray (Gy) at the isocenter was administered in 1–22 fractions. The median calculated biologic effective dose (BED) was 108 Gy (range, 57–180 Gy). RESULTS During follow‐up (median, 24 months; range, 7–78 months), pulmonary complications of National Cancer Institute‐Common Toxicity Criteria Grade > 2 were observed in only 6 patients (2.4%). Local progression occurred in 33 patients (14.5%), and the local recurrence rate was 8.1% for BED ≥ 100 Gy compared with 26.4% for < 100 Gy (P < 0.05). The 3‐year overall survival rate of medically operable patients was 88.4% for BED ≥ 100 Gy compared with 69.4% for < 100 Gy (P < 0.05). CONCLUSIONS Hypofractionated high‐dose STI with BED < 150 Gy was feasible and beneficial for curative treatment of patients with Stage I NSCLC. For all treatment methods and schedules, local control and survival rates were better with BED ≥ 100 Gy compared with < 100 Gy. Survival rates in selected patients (medically operable, BED ≥ 100 Gy) were excellent, and were potentially comparable to those of surgery. Cancer 2004. © 2004 American Cancer Society.

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Section: Discussionmentioning

confidence: 99%

Stereotactic hypofractionated high‐dose irradiation for stage I nonsmall cell lung carcinoma

Oda

Araki

Shirato³

et al. 2004

Cancer

816

438

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“…In [2], The authors presents an efficient algorithm for segmenting different types of pulmonary nodules including high and low contrast nodules, nodules with vasculature attachment, and nodules in the close vicinity of the lung wall or diaphragm. The algorithm performs an adaptive sphericity oriented contrast region growing on the fuzzy connectivity map of the object of interest.…”

Section: Review Of Previous Papersmentioning

confidence: 99%

Computer Aided Diagnosis For the Detection of Lung Nodules

Shivakumar¹

2012

IOSRJEN

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“…The traditional treatment for patients with early stage (I/II) non-small cell lung carcinoma (NSCLC) is surgery [1]. Unfortunately, several counterindications to surgery exist, such as severe comorbidity, chronic obstructive pulmonary disease (COPD) and/or chronic heart disease [2-4].…”

Section: Introductionmentioning

confidence: 99%

The feasibility of evaluating radiation dose to the heart by integrating kilovoltage-cone beam computed tomography in stereotactic body radiotherapy of early non-small-cell lung cancer patients

et al. 2013

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BackgroundTo investigate the feasibility of contouring the planning risk organ volume (PRV) for the heart, and to determine the probability of evaluating radiation dose to the heart using kilovoltage-cone beam computed tomography (kV-CBCT) in early-stage non-small-cell lung cancer (NSCLC) patients, who received stereotactic body radiotherapy (SBRT).Materials and methodsSeventeen NSCLC patients who received SBRT (5Gy/f × 10f dose) were enrolled and subjected to CBCT and CT imaging analyses to plan treatment. Sequential planning CBCT images of individual patient’s hearts were analyzed for reproducibility of heart contouring and volume. Comparative analyses were made between the planning CT- and CBCT-detected heart margins and dose-volume indices for treatment.ResultsThe heart volume from planning CT images was significantly smaller than that from CBCT scans (p < 0.05), and the volumes based on the different series of CBCT images were similar (p > 0.05).The overlap of the heart region on the same anatomical section between the first series of CBCT scans and other scans reached 0.985 ± 0.020 without statistically significant differences (p > 0.05). The mean margins of the heart from planning CT and CBCT scans were 10.5 ± 2.8 mm in the left direction, 5.9 ± 2.8 mm in the right direction, 2.2 ± 1.6 mm in the direction of the head, 3.3 ± 2.2 mm in the direction of the foot, 6.7 ± 1.1 mm in the anterior direction, and 4.5 mm ± 2.5 mm in the posterior direction. All relative and absolute dose-volume indices obtained from CBCT images were significantly larger than those from planning CT scans (p < 0.05), with the exception of the volume in the 5Gy region.ConclusionThe PRV of heart contouring based on kV-CBCT is feasible with good reproducibility. More accurate and objective dose-volume indices may be obtained for NSCLC patients by using kV-CBCT, instead of CT, to plan SBRT.

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Surgical management of early stage lung cancer

Cited by 16 publications

References 92 publications

Stereotactic hypofractionated high‐dose irradiation for stage I nonsmall cell lung carcinoma

Stereotactic hypofractionated high‐dose irradiation for stage I nonsmall cell lung carcinoma

Computer Aided Diagnosis For the Detection of Lung Nodules

The feasibility of evaluating radiation dose to the heart by integrating kilovoltage-cone beam computed tomography in stereotactic body radiotherapy of early non-small-cell lung cancer patients

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