T Stage and Pretreatment Standardized Uptake Values Predict Tumor Recurrence With 5-Fraction SABR in Early-Stage Non-Small Cell Lung Cancer.

Autor:	Hsu EJ; Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas., Mendel JT; Rio Grande Urology, El Paso, Texas., Ward KA; Department of Radiation Oncology, University of Virginia, Charlottesville, Virginia., El-Ashmawy M; Division of Hematology/Oncology, Department of Medicine at Columbia University Medical Center, New York, New York., Lee M; Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas., Choy H; Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas., Westover KD; Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas., Vo DT; Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas., Timmerman RD; Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas., Sher DJ; Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas., Iyengar P; Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas.
Jazyk:	angličtina
Zdroj:	Advances in radiation oncology [Adv Radiat Oncol] 2022 May 21; Vol. 7 (5), pp. 100995. Date of Electronic Publication: 2022 May 21 (Print Publication: 2022).
DOI:	10.1016/j.adro.2022.100995
Abstrakt:	Purpose: Five-fraction stereotactic ablative radiotherapy (SABR) regimens are frequently used to treat centrally located early-stage non-small cell lung cancer or disease in the proximity of the chest wall as a means of optimizing tumor control and reducing treatment toxicity. However, increasing these SABR regimens to 5 fractions may reduce tumor control outcomes. We sought to identify the clinical parameters predictive of treatment failures with these 5-fraction courses. Methods: Ninety patients with T1-2 non-small cell lung cancer were treated with 50 or 60 Gy in 5 fractions. Failure over time was modeled using cumulative incidences of local, regional, or distant failure, with death as a competing risk. Cox proportional hazards analysis for incidences of failure was performed to control for patient variables. Results: Of 90 patients, 24 of 53 patients with T1 tumors and 19 of 37 patients with T2 tumors received 50 Gy SABR, and the other 47 patients received 60 Gy. Two-year overall survival and progression-free survival for the whole cohort were 75.8% and 59.3%, respectively. Total SABR dose (50 vs 60 Gy) did not influence survival nor failure rates at 2 and 5 years. Within 2 years of treatment, 7.8% of all patients developed local failure. For all patient and tumor characteristics evaluated, only T stage and pretreatment positron emission tomography standardized uptake values served as predictors of local, regional, and distant failure at 2 and 5 years posttreatment on univariate and multivariable analysis. Conclusions: Five-fraction SABR provides excellent in-field control. T2 and high fluorodeoxyglucose uptake tumors have increased failure rates, suggesting the potential need for adjuvant therapies, which are being assessed in randomized phase 3 trials.
Databáze:	MEDLINE
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