Use of stereotactic body radiation therapy for medically inoperable multiple primary lung cancer

Matthiesen, Chance; Thompson, John S.; Herman, Terence; Ahmad, Salahuddin; Herman, Terence S.

doi:10.1111/j.1754-9485.2012.02393.x

Cited by 26 publications

(17 citation statements)

References 21 publications

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“…Only a few SBRT studies have been published, with a relatively small number of patients. [15][16][17][18][19] According to previous reports on SBRT containing a relatively large number of SPLC patients, the 2-year OS was 56% to 61%, 18,19 which is comparable to this study. However, direct comparison between studies is difficult and of little meaning because of the small sample size and variation of the patient selection.…”

Section: Discussionsupporting

confidence: 91%

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Stereotactic Body Radiotherapy for Synchronous Primary Lung Cancer: Clinical Outcome of 18 Cases

Satō¹,

Masago²,

Takayama³

et al. 2015

Clinical Lung Cancer

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Section: Discussionsupporting

confidence: 91%

“…To our knowledge, there are few publications discussing the use of SBRT for SPLC. [15][16][17][18][19] This study evaluates the OS, progression pattern, and toxicity of SBRT as a definitive treatment for SPLC.…”

Section: Introductionmentioning

confidence: 99%

Stereotactic Body Radiotherapy for Synchronous Primary Lung Cancer: Clinical Outcome of 18 Cases

Satō¹,

Masago²,

Takayama³

et al. 2015

Clinical Lung Cancer

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“…Previous reviews have demonstrated similar results but with much smaller numbers (10 patients). One report from the University of Oklahoma treated 10 patients with 21 synchronous/metachronous inoperable lung tumours with an 18 month local control rate of 95% [11]. The University of Indiana also published a series on 10 patients with an 18 month local control rate of 80% for patients with bilateral multiple biopsy proven non small cell lung cancers [7].…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Stereotactic Body Radiotherapy (SBRT) treatment of multiple synchronous and recurrent lung nodules

et al. 2015

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BackgroundStereotactic body radiotherapy (SBRT) is evolving into a standard of care for unresectable lung nodules. Local control has been shown to be in excess of 90% at 3 years. However, some patients present with synchronous lung nodules in the ipsilateral or contralateral lobe or metasynchronous disease. In these cases, patients may receive multiple courses of lung SBRT or a single course for synchronous nodules. The toxicity of such treatment is currently unknown.MethodsBetween 2006 and 2012, 63 subjects with 128 metasynchronous and synchronous lung nodules were treated at the Mayo Clinic with SBRT. Demographic patient data and dosimetric data regarding SBRT treatments were collected. Acute toxicity (defined as toxicity < 90 days) and late toxicity (defined as toxicity > = 90 days) were reported and graded as per standardized CTCAE 4.0 criteria. Local control, progression free survival and overall survival were also described.ResultsThe median age of patients treated was 73 years. Sixty five percent were primary or recurrent lung cancers with the remainder metastatic lung nodules of varying histologies. Of 63 patients, 18 had prior high dose external beam radiation to the mediastinum or chest. Dose and fractionation varied but the most common prescriptions were 48 Gy/4 fractions, 54 Gy/3 fractions, and 50 Gy/5 fractions. Only 6 patients demonstrated local recurrence. With a median follow up of 12.6 months, median SBRT specific overall survival and progression free survival were 35.7 months and 10.7 months respectively. Fifty one percent (32/63 patients) experienced acute toxicity, predominantly grade 1 and 2 fatigue. One patient developed acute grade 3 radiation pneumonitis at 75 days. Forty six percent (29/63 patients) developed late effects. Most were grade 1 dyspnea. There was one patient with grade 5 pneumonitis.ConclusionMultiple courses of SBRT and SBRT delivery after external beam radiotherapy appear to be feasible and safe. Most toxicity was grade 1 and 2 but the risk was approximately 50% for both acute and late effects.

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“…The feasibility, safety, and efficacy of SABR for this purpose have been established by retrospective and prospective studies published over the past decade, and this technique has become a new standard of care for patients with medically inoperable stage I nonsmall cell lung cancer (NSCLC). However, the application of SABR for multiple early stage primary lung tumors has been described only rarely . The objective of this study was to explore the role of SABR for patients with MPLC.…”

Section: Introductionmentioning

confidence: 99%

Stereotactic ablative radiotherapy: A potentially curable approach to early stage multiple primary lung cancer

Chang

Liu

Zhu

et al. 2013

Cancer

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BACKGROUND Surgical resection has been the standard treatment for early-stage multiple primary lung cancer (MPLC). However, a significant proportion of patients with MPLC cannot undergo surgery. We explored here the role of stereotactic ablative radiotherapy (SABR) for patients with MPLC. METHODS We reviewed MPLC cases treated with SABR (50 Gy in 4 fractions or 70 Gy in 10 fractions) for the second tumor. Four-dimensional CT–based planning/volumetric image-guided treatment was used for all patients. Treatment outcomes/toxicities were analyzed. RESULTS For the 101 patients treated with SABR, at a median follow-up interval of 36 months and median overall survival of 46 months, 2-year and 4-year in-field local control rates were 97.4% and 95.7%. 2- and 4-year rates of overall survival (OS) were 73.2% and 47.5% and progression-free survival (PFS) were 67.0% and 58.0%. Patients with metachronous tumors had higher OS and PFS than did patients with synchronous tumors (2-year OS 80.6% metachronous vs. 61.5% synchronous; 4-year OS 52.7% vs. 39.7%; p=0.047; 2-year PFS 84.7% vs. 49.4%; 4-year PFS 75.6% vs. 30.4%; p=0.0001). For patients whose index tumor was treated with surgery or SABR, the incidence of grade ≥3 radiation pneumonitis was 3% (2/71), but this increased to 17% (5/30) for patients whose index tumor was treated with conventional radiotherapy. Other grade ≥3 toxicities included grade 3 chest wall pain (3/101, 3%) and grade 3 skin toxicity (1/101, 1%). CONCLUSIONS SABR achieves promising long- term tumor control, survival and could be a potential curative treatment of early-stage MPLC.

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Use of stereotactic body radiation therapy for medically inoperable multiple primary lung cancer

Cited by 26 publications

References 21 publications

Stereotactic Body Radiotherapy for Synchronous Primary Lung Cancer: Clinical Outcome of 18 Cases

Stereotactic Body Radiotherapy for Synchronous Primary Lung Cancer: Clinical Outcome of 18 Cases

Outcomes of Stereotactic Body Radiotherapy (SBRT) treatment of multiple synchronous and recurrent lung nodules

Stereotactic ablative radiotherapy: A potentially curable approach to early stage multiple primary lung cancer

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