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Int J Radiat Oncol Biol Phys. 2011 Nov 15;81(4):e299-303. doi: 10.1016/j.ijrobp.2011.01.038. Epub 2011 Apr 7.

Dose-response for stereotactic body radiotherapy in early-stage non-small-cell lung cancer.

Author information

1
Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO 63110, USA.

Abstract

PURPOSE:

To compare the efficacy of three lung stereotactic body radiotherapy (SBRT) regimens in a large institutional cohort.

METHODS:

Between 2004 and 2009, 130 patients underwent definitive lung cancer SBRT to a single lesion at the Mallinckrodt Institute of Radiology. We delivered 18 Gy × 3 fractions for peripheral tumors (n = 111) and either 9 Gy × 5 fractions (n = 8) or 10 Gy × 5 fractions (n = 11) for tumors that were central or near critical structures. Univariate and multivariate analysis of prognostic factors was performed using the Cox proportional hazard model.

RESULTS:

Median follow-up was 11, 16, and 13 months for the 9 Gy × 5, 10 Gy × 5, and 18 Gy × 3 groups, respectively. Local control statistics for Years 1 and 2 were, respectively, 75% and 50% for 9 Gy × 5, 100% and 100% for 10 Gy × 5, and 99% and 91% for 18 Gy × 3. Median overall survival was 14 months, not reached, and 34 months for the 9 Gy × 5, 10 Gy × 5, and 18 Gy × 3 treatments, respectively. No difference in local control or overall survival was found between the 10 Gy × 5 and 18 Gy × 3 groups on log-rank test, but both groups had improved local control and overall survival compared with 9 Gy × 5. Treatment with 9 Gy × 5 was the only independent prognostic factor for reduced local control on multivariate analysis, and increasing age, increasing tumor volume, and poor performance status predicted independently for reduced overall survival.

CONCLUSION:

Treatment regimens of 10 Gy × 5 and 18 Gy × 3 seem to be efficacious for lung cancer SBRT and provide superior local control and overall survival compared with 9 Gy × 5.

PMID:
21477948
DOI:
10.1016/j.ijrobp.2011.01.038
[Indexed for MEDLINE]

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