We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
7-year follow-up after stereotactic ablative radiotherapy for patients with stage I non-small cell lung cancer: Results of a phase 2 clinical trial.
- Authors
Sun, Bing; Brooks, Eric D.; Komaki, Ritsuko U.; Liao, Zhongxing; Jeter, Melenda D.; McAleer, Mary F.; Allen, Pamela K.; Balter, Peter A.; Welsh, James D.; O'Reilly, Michael S; Gomez, Daniel; Hahn, Stephen M.; Roth, Jack A.; Mehran, Reza J.; Heymach, John V.; Chang, Joe Y.
- Abstract
<bold>Background: </bold>The authors evaluated the efficacy, patterns of failure, and toxicity of stereotactic ablative radiotherapy (SABR) for patients with medically inoperable, clinical stage I non-small cell lung cancer (NSCLC) in a prospective clinical trial with 7 years of follow-up. Clinical staging was performed according to the seventh edition of the American Joint Committee on Cancer TNM staging system.<bold>Methods: </bold>Eligible patients with histologically confirmed NSCLC of clinical stage I as determined using positron emission tomography staging were treated with SABR (50 grays in 4 fractions). The primary endpoint was progression-free survival. Patients were followed with computed tomography and/or positron emission tomography/computed tomography every 3 months for the first 2 years, every 6 months for the next 3 years, and then annually thereafter.<bold>Results: </bold>A total of 65 patients were eligible for analysis. The median age of the patients was 71 years, and the median follow-up was 7.2 years. A total of 18 patients (27.7%) developed disease recurrence at a median of 14.5 months (range, 4.3-71.5 months) after SABR. Estimated incidences of local, regional, and distant disease recurrence using competing risk analysis were 8.1%, 10.9%, and 11.0%, respectively, at 5 years and 8.1%, 13.6%, and 13.8%, respectively, at 7 years. A second primary lung carcinoma developed in 12 patients (18.5%) at a median of 35 months (range, 5-67 months) after SABR. Estimated 5-year and 7-year progression-free survival rates were 49.5% and 38.2%, respectively; the corresponding overall survival rates were 55.7% and 47.5%, respectively. Three patients (4.6%) experienced grade 3 treatment-related adverse events. No patients developed grade 4 or 5 adverse events (toxicity was graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events [version 3.0]).<bold>Conclusions: </bold>With long-term follow-up, the results of the current prospective study demonstrated outstanding local control and low toxicity after SABR in patients with clinical stage I NSCLC. Regional disease recurrence and distant metastases were the dominant manifestations of failure. Surveillance for second primary lung carcinoma is recommended. Cancer 2017;123:3031-39. © 2017 American Cancer Society.
- Subjects
RADIOTHERAPY; SMALL cell lung cancer; CLINICAL trials; POSITRON emission tomography; COMPUTED tomography; ADENOCARCINOMA; CANCER relapse; COMPARATIVE studies; LONGITUDINAL method; LUNG cancer; LUNG tumors; RESEARCH methodology; MEDICAL cooperation; PROGNOSIS; RADIOSURGERY; RESEARCH; RESEARCH funding; SQUAMOUS cell carcinoma; TUMOR classification; EVALUATION research; TREATMENT effectiveness; SECONDARY primary cancer
- Publication
Cancer (0008543X), 2017, Vol 123, Issue 16, p3031
- ISSN
0008-543X
- Publication type
journal article
- DOI
10.1002/cncr.30693