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Stereotactic Body Radiotherapy for Medically Inoperable Lung Cancer: Prospective, Single-Center Study of 108 Consecutive Patients

2011; Elsevier BV; Volume: 82; Issue: 2 Linguagem: Inglês

10.1016/j.ijrobp.2010.12.039

1879-355X

Mojgan Taremi, Andrew Hope, Max Dahele, Shannon Pearson, Sharon Fung, Thomas G. Purdie, Anthony Brade, John Cho, A. Sun, Jean‐Pierre Bissonnette, Andrea Bezjak,

Medical Imaging Techniques and Applications

PurposeTo present the results of stereotactic body radiotherapy (SBRT) for medically inoperable patients with Stage I non–small-cell lung cancer (NSCLC) and contrast outcomes in patients with and without a pathologic diagnosis.Methods and MaterialsBetween December 2004 and October 2008, 108 patients (114 tumors) underwent treatment according to the prospective research ethics board-approved SBRT protocols at our cancer center. Of the 108 patients, 88 (81.5%) had undergone pretreatment whole-body [18F]-fluorodeoxyglucose positron emission tomography/computed tomography. A pathologic diagnosis was unavailable for 33 (28.9%) of the 114 lesions. The SBRT schedules included 48 Gy in 4 fractions or 54–60 Gy in 3 fractions for peripheral lesions and 50–60 Gy in 8–10 fractions for central lesions. Toxicity and radiologic response were assessed at the 3–6-month follow-up visits using conventional criteria.ResultsThe mean tumor diameter was 2.4-cm (range, 0.9–5.7). The median follow-up was 19.1 months (range, 1–55.7). The estimated local control rate at 1 and 4 years was 92% (95% confidence interval [CI], 86–97%) and 89% (95% CI, 81–96%). The cause-specific survival rate at 1 and 4 years was 92% (95% CI, 87–98%) and 77% (95% CI, 64–89%), respectively. No statistically significant difference was found in the local, regional, and distant control between patients with and without pathologically confirmed NSCLC. The most common acute toxicity was Grade 1 or 2 fatigue (53 of 108 patients). No toxicities of Grade 4 or greater were identified.ConclusionsLung SBRT for early-stage NSCLC resulted in excellent local control and cause-specific survival with minimal toxicity. The disease-specific outcomes were comparable for patients with and without a pathologic diagnosis. SBRT can be considered an option for selected patients with proven or presumed early-stage NSCLC.