Survival Outcome After Stereotactic Body Radiation Therapy and Surgery for Stage I Non-Small Cell Lung Cancer: A Meta-Analysis

Zheng, Xiangpeng; Schipper, Matthew J.; Kidwell, Kelley M.; Lin, Jules; Reddy, Rishindra M.; Ren, Yan‐Ping; Chang, Andrew C.; Lv, Fanzhen; Orringer, Mark B.; Kong, Feng Ming

doi:10.1016/j.ijrobp.2014.05.055

Cited by 226 publications

(147 citation statements)

References 30 publications

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“…The larger studies have shown improved OS in the surgery groups; however, these are usually confounded by older patients with more comorbidities in the SABR arms due to inoperability. [72][73][74][75][76] van den Berg et al 78 report outcomes of 340 patients treated with surgery (n 5 143) or SABR (n 5 197) for ES lung cancer. They found no difference in OS, local recurrence or distant recurrence.…”

Section: Introductionmentioning

confidence: 99%

A systematic review of outcomes following stereotactic ablative radiotherapy in the treatment of early-stage primary lung cancer

Murray

Franks

Hanna

2017

The British Journal of Radiology

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Stereotactic ablative body radiotherapy (SABR) describes a radiotherapy (RT) technique where high doses of radiation are precisely delivered to an extracranial target within the body, using either a single fraction of RT or using multiple small numbers of fractions. SABR has now become the standard of care treatment for patients with early-stage non-small-cell lung cancer (NSCLC) for whom surgery is not appropriate. This systematic review considers the evidence supporting the use of SABR in early-stage NSCLC, reported toxicity rates, the use of SABR in centrally located NSCLC, the use of SABR as salvage therapy following surgery or RT, and future potential drug combinations with SABR.

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Section: Introductionmentioning

confidence: 99%

A systematic review of outcomes following stereotactic ablative radiotherapy in the treatment of early-stage primary lung cancer

Murray

Franks

Hanna

2017

The British Journal of Radiology

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“…SBRT has been shown to provide effective local control with acceptable toxicity 3. It is the preferred treatment modality for medically inoperable stage I non‐small‐cell lung cancer (NSCLC) patients, and there is emerging evidence and investigation regarding its role for selected operable NSCLC patients,4, 5, 6 as well as for stage I small‐cell lung cancer patients 7, 8…”

Section: Introductionmentioning

confidence: 99%

Exploratory analysis using machine learning to predict for chest wall pain in patients with stage I non‐small‐cell lung cancer treated with stereotactic body radiation therapy

Chao

Valdés

Luna

et al. 2018

J Applied Clin Med Phys

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Background and purposeChest wall toxicity is observed after stereotactic body radiation therapy (SBRT) for peripherally located lung tumors. We utilize machine learning algorithms to identify toxicity predictors to develop dose–volume constraints.Materials and methodsTwenty‐five patient, tumor, and dosimetric features were recorded for 197 consecutive patients with Stage I NSCLC treated with SBRT, 11 of whom (5.6%) developed CTCAEv4 grade ≥2 chest wall pain. Decision tree modeling was used to determine chest wall syndrome (CWS) thresholds for individual features. Significant features were determined using independent multivariate methods. These methods incorporate out‐of‐bag estimation using Random forests (RF) and bootstrapping (100 iterations) using decision trees.ResultsUnivariate analysis identified rib dose to 1 cc < 4000 cGy (P = 0.01), chest wall dose to 30 cc < 1900 cGy (P = 0.035), rib Dmax < 5100 cGy (P = 0.05) and lung dose to 1000 cc < 70 cGy (P = 0.039) to be statistically significant thresholds for avoiding CWS. Subsequent multivariate analysis confirmed the importance of rib dose to 1 cc, chest wall dose to 30 cc, and rib Dmax. Using learning‐curve experiments, the dataset proved to be self‐consistent and provides a realistic model for CWS analysis.ConclusionsUsing machine learning algorithms in this first of its kind study, we identify robust features and cutoffs predictive for the rare clinical event of CWS. Additional data in planned subsequent multicenter studies will help increase the accuracy of multivariate analysis.

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“…Each platform engages a variety of machine components to track motion resulting from respiration motion, heartbeat, or digestion. Lung radiosurgery has had clinical success 17,18 , rendering the modality a novel treatment option in radiation oncology 19,20 . This how-to article provides one new radiation therapy protocol that describes dynamic lung tumor tracking for therapeutic treatment intent.…”

Section: Introductionmentioning

confidence: 99%

Dynamic Lung Tumor Tracking for Stereotactic Ablative Body Radiation Therapy

Kunos

Fabien

Shanahan

et al. 2015

JoVE

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Physicians considering stereotactic ablative body radiation therapy (SBRT) for the treatment of extracranial cancer targets must be aware of the sizeable risks for normal tissue injury and the hazards of physical tumor miss. A first-of-its-kind SBRT platform achieves high-precision ablative radiation treatment through a combination of versatile real-time imaging solutions and sophisticated tumor tracking capabilities. It uses dualdiagnostic kV x-ray units for stereoscopic open-loop feedback of cancer target intrafraction movement occurring as a consequence of respiratory motions and heartbeat. Image-guided feedback drives a gimbaled radiation accelerator (maximum 15 x 15 cm field size) capable of real-time ±4 cm pan-and-tilt action. Robot-driven ±60° pivots of an integrated ±185° rotational gantry allow for coplanar and non-coplanar accelerator beam set-up angles, ultimately permitting unique treatment degrees of freedom. State-of-the-art software aids real-time six dimensional positioning, ensuring irradiation of cancer targets with sub-millimeter accuracy (0.4 mm at isocenter). Use of these features enables treating physicians to steer radiation dose to cancer tumor targets while simultaneously reducing radiation dose to normal tissues. By adding respiration correlated computed tomography (CT) and 2-[ . In this article, we describe new radiation plans for the treatment of moving lung tumors.

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Survival Outcome After Stereotactic Body Radiation Therapy and Surgery for Stage I Non-Small Cell Lung Cancer: A Meta-Analysis

Cited by 226 publications

References 30 publications

A systematic review of outcomes following stereotactic ablative radiotherapy in the treatment of early-stage primary lung cancer

A systematic review of outcomes following stereotactic ablative radiotherapy in the treatment of early-stage primary lung cancer

Exploratory analysis using machine learning to predict for chest wall pain in patients with stage I non‐small‐cell lung cancer treated with stereotactic body radiation therapy

Dynamic Lung Tumor Tracking for Stereotactic Ablative Body Radiation Therapy

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