Dose–effect relationship of stereotactic body radiotherapy in non-small cell lung cancer patients

Abstract

Objective To establish the dose effect relationship between the dose parameters of stereotactic body radiation therapy (SBRT) for early non-small cell lung cancer (NSCLC) and the local tumor control rate. Materials and methods A comprehensive literature search was conducted using PubMed, the Web of Science and the Cochrane databases to determine the articles treated with SBRT in early-stage NSCLC. Original studies with complete prescription dose information, tumor local control rate and other important parameters were screened and reported. Probit model in XLSTAT 2016 was used for regression analysis, and P < 0.05 was set as a statistically significant level. Results After literature screening, 22 eligible studies were included in probit model regression analysis, involving 1861 patients. There is no significant dose effect relationship between nominal BED10 and peripheral BED10 versus 3 years local control probability. There were significant dose effect relationships between the center BED10 and the average BED10 versus the 3 years local control probability, with P values are 0.001 and < 0.0001, respectively. According to the results of this model, the 3 years local control rate of 90.5% (87.5–92.1%) and 89.5% (86.7–91.0%) can be expected at the center BED10 of 180 Gy or the average BED10 of 140 Gy, prospectively. Conclusions For NSCLC treated with SBRT, more attention should be paid to the central dose and average dose of PTV. A set of clear definition in the dose prescription should be established to ensure the effectiveness and comparability of treatment.

The role of online MR-guided multi-fraction stereotactic ablative radiotherapy in lung tumours

“…Thus, in our analysis by increasing the BED (notably assuming an α/β ratio of about 10 Gy) in reoptimised plans, increase in local TCP was potentially achieved. Conversely, a recently published analysis using a Probit model determined not only BED 10 at the isocenter but also mean BED 10 to be the strongest predictors of 3-year TCD90 for NSCLC treated with SBRT [41] . In our analysis, the mean dose barely changes with plan adaptation.…”

Dose-effect relationship of linear accelerator based stereotactic radiotherapy for brain metastases

“…This study has some limitations that have been discussed in previous articles [ 10 , 11 ]. Besides, BMs belong to the advanced stage of patients with cancer, and tumour control is influenced by many factors, such as primary tumour control, extracranial metastases, and pathology.…”

“…Referring to the dose-response effect and dose-toxicity study of SRT for BM [ 8 ], in our study, the α/β value was also set to 10. Due to the high heterogeneity of the PTV dose in SRT, to facilitate the dose effect analysis, we defined the nominal dose, peripheral dose, central dose and average dose as previously described [ 10 ]. Conducting dose-effect analyses of multiple BED parameters enables us to delve deeper into the factors that have a stronger correlation with tumor control.…”