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Factors important for efficacy of stereotactic body radiotherapy of medically inoperable stage I lung cancer. A retrospective analysis of patients treated in the Nordic countries

Baumann, Pia ; Nyman, Jan ; Lax, Ingmar ; Friesland, Signe ; Hoyer, Morten ; Ericsson, Suzanne Rehn ; Johansson, Karl-Axel ; Ekberg, Lars ; Morhed, Elisabeth and Paludan, Merete , et al. (2006) In Acta Oncologica 45(7). p.787-795
Abstract
We reviewed results of SBRT treatment of 138 patients with medically inoperable stage I NSCLC treated during 1996 - 2003 at five different centres in Sweden and Denmark. Mean age was 74 years ( range 56 - 90) with 69 men and 72 women. SBRT was delivered using a 3D conformal multifield technique and a stereotactic body frame. Doses delivered were 30 - 48 Gy (65% isodose at the periphery of planning target volume, PTV) in 2 - 4 fractions. Equivalent dose in 2 Gy fractions (EQD2) was in the range of 50 - 100 Gy. Mean gross tumour volume (GTV) was 39 cm(3) (2 - 436), and planning target volume was 101 cm(3) (11 - 719). Overall response rate (CR, PR) was 61% (84/138). SD was noted in 36% (50/138). During a median follow-up period of 33 months... (More)
We reviewed results of SBRT treatment of 138 patients with medically inoperable stage I NSCLC treated during 1996 - 2003 at five different centres in Sweden and Denmark. Mean age was 74 years ( range 56 - 90) with 69 men and 72 women. SBRT was delivered using a 3D conformal multifield technique and a stereotactic body frame. Doses delivered were 30 - 48 Gy (65% isodose at the periphery of planning target volume, PTV) in 2 - 4 fractions. Equivalent dose in 2 Gy fractions (EQD2) was in the range of 50 - 100 Gy. Mean gross tumour volume (GTV) was 39 cm(3) (2 - 436), and planning target volume was 101 cm(3) (11 - 719). Overall response rate (CR, PR) was 61% (84/138). SD was noted in 36% (50/138). During a median follow-up period of 33 months (1 - 107), 16 (12%) local failures occurred, ten of which also included distant metastases. Local failure was associated with tumour size, target definition and central or pleura proximity. Distant metastases occurred in 25% (35/138) of the patients. Ninety-one ( 65%) patients died during follow-up of which 55 patients (60%) died of other causes than lung cancer. Three- and 5-year overall survival was 52 and 26% respectively. Lung cancer specific 3- and 5-year overall survival was 66 and 40% respectively. Fifty nine percent (83/138) of the patients had no side effects. Fourteen patients experienced grade 3 - 4 toxicity according to radiation therapy oncology group (RTOG). EQD2 (> v.s. < 55.6 Gy) showed a statistically significant benefit survival for the higher doses. SBRT for stage I NSCLC results in favourable local control not inferior to fractionated RT and with acceptable toxicity. (Less)
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Acta Oncologica
volume
45
issue
7
pages
787 - 795
publisher
Taylor & Francis
external identifiers
  • wos:000240569600004
  • scopus:33748851899
ISSN
1651-226X
DOI
10.1080/02841860600904862
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English
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@article{7ab9f76d-3c2e-4853-804a-92cbc2be2eb5,
  abstract     = {We reviewed results of SBRT treatment of 138 patients with medically inoperable stage I NSCLC treated during 1996 - 2003 at five different centres in Sweden and Denmark. Mean age was 74 years ( range 56 - 90) with 69 men and 72 women. SBRT was delivered using a 3D conformal multifield technique and a stereotactic body frame. Doses delivered were 30 - 48 Gy (65% isodose at the periphery of planning target volume, PTV) in 2 - 4 fractions. Equivalent dose in 2 Gy fractions (EQD2) was in the range of 50 - 100 Gy. Mean gross tumour volume (GTV) was 39 cm(3) (2 - 436), and planning target volume was 101 cm(3) (11 - 719). Overall response rate (CR, PR) was 61% (84/138). SD was noted in 36% (50/138). During a median follow-up period of 33 months (1 - 107), 16 (12%) local failures occurred, ten of which also included distant metastases. Local failure was associated with tumour size, target definition and central or pleura proximity. Distant metastases occurred in 25% (35/138) of the patients. Ninety-one ( 65%) patients died during follow-up of which 55 patients (60%) died of other causes than lung cancer. Three- and 5-year overall survival was 52 and 26% respectively. Lung cancer specific 3- and 5-year overall survival was 66 and 40% respectively. Fifty nine percent (83/138) of the patients had no side effects. Fourteen patients experienced grade 3 - 4 toxicity according to radiation therapy oncology group (RTOG). EQD2 (&gt; v.s. &lt; 55.6 Gy) showed a statistically significant benefit survival for the higher doses. SBRT for stage I NSCLC results in favourable local control not inferior to fractionated RT and with acceptable toxicity.},
  author       = {Baumann, Pia and Nyman, Jan and Lax, Ingmar and Friesland, Signe and Hoyer, Morten and Ericsson, Suzanne Rehn and Johansson, Karl-Axel and Ekberg, Lars and Morhed, Elisabeth and Paludan, Merete and Wittgren, Lena and Blomgren, Henrik and Lewensohn, Rolf},
  issn         = {1651-226X},
  language     = {eng},
  number       = {7},
  pages        = {787--795},
  publisher    = {Taylor & Francis},
  series       = {Acta Oncologica},
  title        = {Factors important for efficacy of stereotactic body radiotherapy of medically inoperable stage I lung cancer. A retrospective analysis of patients treated in the Nordic countries},
  url          = {http://dx.doi.org/10.1080/02841860600904862},
  doi          = {10.1080/02841860600904862},
  volume       = {45},
  year         = {2006},
}