Local Tumor Control After Stereotactic Body Radiation Therapy for Early Lung Cancer is Not Impacted by the Use of Intensity Modulated Radiation Therapy or Respiratory Gating

Nsouli, Tamara; Frandina, John; Tanny, S; Chaudhari, R.; Rosenbaum, Paula F.; Mix, M.; Aridgides, Paul

doi:10.1016/j.ijrobp.2017.06.1767

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“…However, no differences with regard to local failure or survival according to the mode of delivery (3DCRT or IMRT) were observed, which is the subject of our subsequent report. 33 …”

Section: Discussionmentioning

confidence: 99%

Clinical outcomes following advanced respiratory motion management (respiratory gating or dynamic tumor tracking) with stereotactic body radiation therapy for stage I non-small-cell lung cancer

Aridgides

Nsouli

Chaudhari

et al. 2018

LCTT

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PurposeTo report the outcomes of stereotactic body radiation therapy (SBRT) for stage I non-small-cell lung cancer (NSCLC) according to respiratory motion management method.MethodsPatients with stage I NSCLC who received SBRT from 2007 to 2015 were reviewed. Computed tomography (CT) simulation with four-dimensional CT was performed for respiratory motion assessment. Tumor motion >1 cm in the craniocaudal direction was selectively treated with advanced respiratory management: either respiratory gating to a pre-specified portion of the respiratory cycle or dynamic tracking of an implanted fiducial marker. Comparisons were made with internal target volume approach, which treated all phases of respiratory motion.ResultsOf 297 patients treated with SBRT at our institution, 51 underwent advanced respiratory management (48 with respiratory gating and three with tumor tracking) and 246 underwent all-phase treatment. Groups were similarly balanced with regard to mean age (P=0.242), tumor size (P=0.315), and histology (P=0.715). Tumor location in the lower lung lobes, as compared to middle or upper lobes, was more common in those treated with advanced respiratory management (78.4%) compared to all-phase treatment (25.6%, P<.0001). There were 17 local recurrences in the treated lesions. Kaplan–Meier analyses showed that there were no differences with regard to mean time to local failure (91.5 vs 98.8 months, P=0.56), mean time to any failure (73.2 vs 78.7 months, P=0.73), or median overall survival (43.3 vs 45.5 months, P=0.56) between patients who underwent advanced respiratory motion management and all-phase treatment.ConclusionSBRT with advanced respiratory management (the majority with respiratory gating) showed similar efficacy to all-phase treatment approach for stage I NSCLC.

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“…However, no differences with regard to local failure or survival according to the mode of delivery (3DCRT or IMRT) were observed, which is the subject of our subsequent report. 33 …”

Section: Discussionmentioning

confidence: 99%