Portal de Periódicos da CAPES

Locoregional and distant failure following image-guided stereotactic body radiation for early-stage primary lung cancer

2011; Elsevier BV; Volume: 99; Issue: 1 Linguagem: Inglês

10.1016/j.radonc.2011.02.006

1879-0887

Sameer K. Nath, Ajay Sandhu, Daniel Kim, Anjali Bharne, Polly D. Nobiensky, Joshua D. Lawson, Mark M. Fuster, Lyudmila Bazhenova, William Y. Song, Arno J. Mundt,

Lung Cancer Treatments and Mutations

Purpose To report our institutional experience using image-guided stereotactic body radiation therapy (SBRT) for early stage lung cancer, including an analysis into factors associated with nodal and distant failures (NF, DF). Methods Forty-eight patients with early-stage primary lung cancer were treated with image-guided SBRT between 2007 and 2009. Median prescription dose was 48 Gy in 4 fractions. Toxicity was graded according to the NCI CTCAE v3.0 scale. Results Local failure was detected in two lesions and actuarial 24-month local control was 95%. At 24 months, the cumulative incidence of NF was 6%, and DF was 29%. Larger lesions (>3 cm) and younger age (<70 years) were the only factors found to be significantly correlated with increased DF (p = 0.005 and p = 0.015, respectively). A single grade ⩾3 toxicity was observed. After adjusting for age and lesion size, distant failure was significantly associated with a poorer OS (Cox regression, p = 0.0059). Conclusion Image-guided SBRT can produce excellent LC rates with minimal toxicity. Distant failure was a major determinant of OS and the most common pattern of failure, indicating a potential role for systemic therapy in younger patients with large lesions.