Stereotactic radiotherapy of histologically proven inoperable stage i non-small cell lung cancer: Patterns of failure

Nicolaus Andratschke, Frank Zimmermann, Eva Boehm, Sabine Schill, Christine Schoenknecht, Reinhard Thamm, Michael Molls, Carsten Nieder, Hans Geinitz

Research output: Contribution to journalArticlepeer-review

100 Scopus citations

Abstract

Background and purpose: To report patterns of failure of stereotactic body radiation therapy (SBRT) in inoperable patients with histologically confirmed stage I NSCLC. Materials and methods: Ninety-two inoperable patients (median age: 75 years) with clinically staged, histologically proven T1 (n = 31) or T2 (n = 61), N0, M0 non-small cell lung cancer (NSCLC) were included in this study. Treatment consisted of 3-5 fractions with 7-15 Gy per fraction prescribed to the 60% isodose. Results: Freedom from local recurrence at 1, 3 and 5 years was 89%, 83% and 83%, respectively. All 10 local failures were observed in patients with T2 tumors. Isolated regional recurrence was observed in 7.6%. The crude rate of distant progression was 20.7%. Overall survival at 1, 3, and 5 years was 79%, 38% and 17% with a median survival of 29 months. Disease specific survival at 1, 3, and 5 years was 93%, 64% and 48%. Karnofsky performance status, T stage, gross tumor volume and tumor location had no significant impact on overall and disease specific survival. SBRT was generally well tolerated and all patients completed therapy as planned. Conclusion: SBRT for stage I lung cancer is very well tolerated in this patient cohort with significant cardiopulmonal comorbidity and results in excellent local control rates, although a considerable portion develops regional and distant metastases.

Original languageEnglish
Pages (from-to)245-249
Number of pages5
JournalRadiotherapy and Oncology
Volume101
Issue number2
DOIs
StatePublished - Nov 2011

Keywords

  • Lung cancer
  • Radiation therapy
  • SBRT
  • Stage I
  • Stereotactic radiotherapy

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