Use of Stereotactic Ablative Radiotherapy (SABR) in Non–Small Cell Lung Cancer Measuring More Than 5 cm
| Autor: | Suresh Senan, Esther J. Nossent, Max Dahele, Saar van ’t Hof, Ben J. Slotman, H. Tekatli, Wilko F.A.R. Verbakel |
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| Přispěvatelé: | CCA - Cancer Treatment and quality of life, Radiation Oncology, Pulmonary medicine |
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Pulmonary and Respiratory Medicine Male Lung Neoplasms medicine.medical_treatment Population Adenocarcinoma SABR volatility model Radiosurgery 03 medical and health sciences 0302 clinical medicine Risk Factors Carcinoma Non-Small-Cell Lung medicine Humans Lung cancer education Aged Aged 80 and over education.field_of_study Lung business.industry Interstitial lung disease Middle Aged medicine.disease Prognosis Comorbidity Radiation therapy Survival Rate 030104 developmental biology medicine.anatomical_structure Oncology 030220 oncology & carcinogenesis Toxicity Carcinoma Squamous Cell Female Dose Fractionation Radiation Neoplasm Recurrence Local Nuclear medicine business Follow-Up Studies |
| Zdroj: | Journal of Thoracic Oncology, 12(6), 974-982. International Association for the Study of Lung Cancer Tekatli, H, van ’t Hof, S, Nossent, E J, Dahele, M, Verbakel, W F A R, Slotman, B J & Senan, S 2017, ' Use of Stereotactic Ablative Radiotherapy (SABR) in Non–Small Cell Lung Cancer Measuring More Than 5 cm ', Journal of Thoracic Oncology, vol. 12, no. 6, pp. 974-982 . https://doi.org/10.1016/j.jtho.2017.02.021 |
| ISSN: | 1556-0864 |
| DOI: | 10.1016/j.jtho.2017.02.021 |
| Popis: | Introduction Stereotactic ablative radiotherapy (SABR) is currently not the guideline-recommended treatment for lung tumors measuring more than 5 cm. However, improvements in radiotherapy techniques have led to increasing use of SABR for larger tumors. Methods We analyzed the clinical outcomes in patients with a primary or recurrent NSCLC measuring more than 5 cm and treated with five or eight fractions of SABR at our center. Patients who had prior thoracic radiotherapy were excluded. Results A total of 63 consecutive patients with a median tumor diameter of 5.8 cm (range 5.1–10.4) were identified; 81% had T2N0 disease and 18% had T3N0 disease. The median Charlson comorbidity index was 2 (range 0–6). After a median follow-up of 54.7 months, median survival was 28.3 months. Disease-free survival at 2 years was 82.1%, and the local, regional, and distant control rates at 2 years were 95.8%, 93.7%, and 83.6%, respectively. An out-of-field distant recurrence at one or more sites was the most common pattern of failure (10%). Grade 3 or higher toxicity was recorded in 30% of patients, with radiation pneumonitis being the most common toxicity (19%). A likely (n = 4) or possible (n = 8) treatment-related death was scored in 19% of patients. There was preexisting interstitial lung disease in eight patients (13%), with fatal toxicity developing in five of them (63%). Conclusions Lung SABR in tumors larger than 5 cm resulted in high local control rates and acceptable survival outcomes in a patient population with appreciable comorbidity. Patients with interstitial lung disease should be considered a very high-risk population for SABR. |
| Databáze: | OpenAIRE |
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