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- Title
Clinical outcomes of stage I and IIA non-small cell lung cancer patients treated with stereotactic body radiotherapy using a real-time tumor-tracking radiotherapy system.
- Authors
Norio Katoh; Itaru Soda; Hiroyasu Tamamura; Shotaro Takahashi; Yusuke Uchinami; Hiromichi Ishiyama; Kiyotaka Ota; Tetsuya Inoue; Rikiya Onimaru; Keiko Shibuya; Kazushige Hayakawa; Hiroki Shirato; Katoh, Norio; Soda, Itaru; Tamamura, Hiroyasu; Takahashi, Shotaro; Uchinami, Yusuke; Ishiyama, Hiromichi; Ota, Kiyotaka; Inoue, Tetsuya
- Abstract
<bold>Purpose: </bold>To investigate the clinical outcomes of stage I and IIA non-small cell lung cancer (NSCLC) patients treated with stereotactic body radiotherapy (SBRT) using a real-time tumor-tracking radiotherapy (RTRT) system.<bold>Materials and Methods: </bold>Patterns-of-care in SBRT using RTRT for histologically proven, peripherally located, stage I and IIA NSCLC was retrospectively investigated in four institutions by an identical clinical report format. Patterns-of-outcomes was also investigated in the same manner.<bold>Results: </bold>From September 2000 to April 2012, 283 patients with 286 tumors were identified. The median age was 78 years (52-90) and the maximum tumor diameters were 9 to 65 mm with a median of 24 mm. The calculated biologically effective dose (10) at the isocenter using the linear-quadratic model was from 66 Gy to 126 Gy with a median of 106 Gy. With a median follow-up period of 28 months (range 0-127), the overall survival rate for the entire group, for stage IA, and for stage IB + IIA was 75%, 79%, and 65% at 2 years, and 64%, 70%, and 50% at 3 years, respectively. In the multivariate analysis, the favorable predictive factor was female for overall survival. There were no differences between the clinical outcomes at the four institutions. Grade 2, 3, 4, and 5 radiation pneumonitis was experienced by 29 (10.2%), 9 (3.2%), 0, and 0 patients. The subgroup analyses revealed that compared to margins from gross tumor volume (GTV) to planning target volume (PTV) ≥ 10 mm, margins < 10 mm did not worsen the overall survival and local control rates, while reducing the risk of radiation pneumonitis.<bold>Conclusions: </bold>This multi-institutional retrospective study showed that the results were consistent with the recent patterns-of-care and patterns-of-outcome analysis of SBRT. A prospective study will be required to evaluate SBRT using a RTRT system with margins from GTV to PTV < 10mm.
- Subjects
CANCER treatment; STEREOTACTIC radiotherapy; NON-small-cell lung carcinoma; H2 control; DRUG dosage; LONGITUDINAL method; PATIENTS; ADENOCARCINOMA; LUNG cancer; LUNG tumors; MAGNETIC resonance imaging; PROGNOSIS; RADIATION; RADIATION doses; RADIOSURGERY; SQUAMOUS cell carcinoma; SURVIVAL; TUMOR classification; COMPUTER systems; RETROSPECTIVE studies
- Publication
Radiation Oncology, 2017, Vol 12, p1
- ISSN
1748-717X
- Publication type
journal article
- DOI
10.1186/s13014-016-0742-3