Stereotactic body radiation therapy for stage I non-small cell lung carcinomas: Moderate hypofractionation optimizes outcome

Menoux, I.; Antoni, D.; Truntzer, P.; Keller, Andrew; Massard, Gilbert; Noël, Georges

doi:10.1016/j.lungcan.2018.11.013

Cited by 9 publications

(10 citation statements)

References 31 publications

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“…In this fragile field, the causes of respiratory decompensation can be multiple, and the retrospective nature of the data does not allow to exclude another aetiology in a formal way. 21 RP after stereotactic hypofractionated radiotherapy seems different from that, better known and observed after normofractionated 3D radiotherapy. Thus, the time of onset is later after stereotactic radiotherapy, usually after 3 months.…”

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confidence: 61%

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Radiographic findings after stereotactic body radiation therapy for stage I non-small cell lung carcinomas: retrospective analysis of 90 patients

Menoux

Antoni

Santelmo³

et al. 2019

J Radiother Pract

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Aim: Stereotactic body radiation therapy for lung tumours can expose patients to radiation pneumonitis (RP) (<6 months after irradiation) and lung fibrosis (beyond 6 months). The aim of this study was to describe post-irradiation radiographics appearances. Materials and methods: This retrospective study of 90 patients with a stage I non-small cell lung carcinoma reports a detailed description of the computed tomography (CT) or positron emission tomography/CT changes that can be observed after treatment, according to modified Kimura score for RP and Koenig’s classification for fibrosis. This evaluation was realised at 1 month and then every 3–4 months, with a median follow-up of 35 months. Results: The most common radiological RP pattern was diffuse consolidation. It appears in a mean time of 4 months and reaches its maximum at 9 months after radiotherapy. Seventy-three per cent of the RP evolved to fibrosis. Most of these findings were encompassed in the 35 Gy isodose. Findings: Radiological parenchymal changes are frequent in the treatment region, which renders the tumour response monitoring by tumour size, particularly by response evaluation criteria in solid tumours, unsuitable.

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confidence: 61%

“…Patient's and radiation's characteristics were detailed in a previously published article. 21 The median prescribed dose was 60 Gy (30-62.5) delivered in a median of eight fractions (3)(4)(5)(6)(7)(8). Seventyseven patients (87%) received 60 Gy delivered in eight fractions of 7.5 Gy.…”

Section: Patients Characteristics and Radiation Preparationmentioning

confidence: 99%

Radiographic findings after stereotactic body radiation therapy for stage I non-small cell lung carcinomas: retrospective analysis of 90 patients

Menoux

Antoni

Santelmo³

et al. 2019

J Radiother Pract

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“…Crizotinib, a first-in-class ALK/ROS1/MET inhibitor, has been evaluated in two randomized phase III trials (PROFILE 1014 and 1007). Compared to first- and second-line cytotoxic chemotherapeutic drugs, crizotinib significantly improved the overall response rate, progression-free survival (PFS) and quality of life [ 7 , 8 , 15 ]. In the cohort study of Kwak et al, 82 patients with advanced ALK-positive disease were treated with crizotinib.…”

Section: Alk Inhibitorsmentioning

confidence: 99%

“…Several randomized phase III trials have demonstrated improved efficiency using EGFR or ALK inhibitors with regard to cytotoxic chemotherapies such as platinum agents combined with pemetrexed or docetaxel, indicating that targeted therapies should be the standard care for some selected patients [ 1 , 2 , 3 , 4 ]. In addition, improvements in the field of radiotherapy have led to better outcomes for localized, advanced or oligometastatic NSCLC, with the use of intensity-modulated radiation therapy (IMRT), hypofractionated or ablative stereotactic radiotherapy (SBRT) and image-guided and adaptive radiotherapy [ 5 , 6 , 7 , 8 ]. These local treatments were shown to be effective in primitive tumors as well as in oligometastatic disease and are currently delivered as normofractionated or hypofractionated therapy [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Combining Radiation Therapy with ALK Inhibitors in Anaplastic Lymphoma Kinase-Positive Non-Small Cell Lung Cancer (NSCLC): A Clinical and Preclinical Overview

Antoni

Burckel

Noël

2021

Cancers

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Over the past years, the identification of genetic alterations in oncogenic drivers in non-small cell lung cancer (NSCLC) has significantly and favorably transformed the outcome of patients who can benefit from targeted therapies such as tyrosine kinase inhibitors. Among these genetic alterations, anaplastic lymphoma kinase (ALK) rearrangements were discovered in 2007 and are present in 3–5% of patients with NSCLC. In addition, radiotherapy remains one of the cornerstones of NSCLC treatment. Moreover, improvements in the field of radiotherapy with the use of hypofractionated or ablative stereotactic radiotherapy have led to a better outcome for localized or oligometastatic NSCLC. To date, the effects of the combination of ALK inhibitors and radiotherapy are unclear in terms of safety and efficacy but could potently improve treatment. In this manuscript, we provide a clinical and preclinical overview of combining radiation therapy with ALK inhibitors in anaplastic lymphoma kinase-positive non-small cell lung cancer.

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“…Early-stage lung cancer patients account for 16% of newly diagnosed cases, diagnosed according to the criteria of the American Joint Commission for Cancer stage I or II disease 3 . Currently, surgery is the gold standard for treatment of early-stage NSCLC 4 . However, >20% of patients with early-stage NSCLC are ineligible for surgery because of various factors such as old age, severe impairment of lung function, or other comorbidities 5 .…”

Section: Introductionmentioning

confidence: 99%

Choice of Treatment for Stage IA Non-small Cell Lung Cancer Patients Ineligible for Surgery: Ablation or Stereotactic Body Radiotherapy?

Liang

Xie

et al. 2020

J. Cancer

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To compare the survival outcomes of ablation and stereotactic body radiotherapy (SBRT) in inoperable patients with stage IA non-small cell lung cancer (NSCLC). Patients and Methods: Using the Surveillance, Epidemiology, and End Results (SEER) database, we identified 6,395 patients with stage IA NSCLC who had complete clinical information from 2004 to 2015. Kaplan-Meier analysis was performed to determine the propensity score based on the clinical characteristics of patients with stage IA NSCLC. Overall survival (OS) was compared between patients with stage IA NSCLC who were treated with ablation and SBRT after adjusting, stratifying, or matching. Results: Kaplan-Meier analysis demonstrated no significant difference in survival curves (log-rank, p>0.05) between the ablation and SBRT groups. Compared with the SBRT group, the hazard ratio (HR) (95% confidence interval [CI]) of OS was 0.930 (0.817-1.058, p=0.269) in the ablation group on univariate analysis. On multivariate analysis, similar effects on OS (HR: 0.974, 95% CI: 0.858-1.105, p=0.680) were seen in patients with stage IA NSCLC in both the groups. Conclusions: This study suggests that survival does not differ significantly between patients with stage IA NSCLC treated with ablation and SBRT. These results will be helpful for patients with stage IA NSCLC who are ineligible for surgery.

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Stereotactic body radiation therapy for stage I non-small cell lung carcinomas: Moderate hypofractionation optimizes outcome

Cited by 9 publications

References 31 publications

Radiographic findings after stereotactic body radiation therapy for stage I non-small cell lung carcinomas: retrospective analysis of 90 patients

Radiographic findings after stereotactic body radiation therapy for stage I non-small cell lung carcinomas: retrospective analysis of 90 patients

Combining Radiation Therapy with ALK Inhibitors in Anaplastic Lymphoma Kinase-Positive Non-Small Cell Lung Cancer (NSCLC): A Clinical and Preclinical Overview

Choice of Treatment for Stage IA Non-small Cell Lung Cancer Patients Ineligible for Surgery: Ablation or Stereotactic Body Radiotherapy?

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