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J Radiat Res. 2016 Jun;57(3):265-72. doi: 10.1093/jrr/rrw023. Epub 2016 Mar 16.

Stereotactic body radiotherapy for T3 and T4N0M0 non-small cell lung cancer.

Author information

1
Radiation Oncology Center, Ofuna Chuo Hospital, 6-2-24 Ofuna, Kamakura-shi, Kanagawa 247-0056, Japan Department of Radiology, Keio University School of Medicine.
2
Radiation Oncology Center, Ofuna Chuo Hospital, 6-2-24 Ofuna, Kamakura-shi, Kanagawa 247-0056, Japan takeda@1994.jukuin.keio.ac.jp.
3
Radiation Oncology Center, Ofuna Chuo Hospital, 6-2-24 Ofuna, Kamakura-shi, Kanagawa 247-0056, Japan.
4
Department of Respiratory Medicine, Ofuna Chuo Hospital, 6-2-24 Ofuna, Kamakura-shi, Kanagawa 247-0056, Japan.
5
Department of Thoracic Surgery, Ofuna Chuo Hospital, 6-2-24 Ofuna, Kamakura-shi, Kanagawa 247-0056, Japan.
6
Department of Radiology, Ofuna Chuo Hospital, 6-2-24 Ofuna, Kamakura-shi, Kanagawa 247-0056, Japan.
7
Department of Thoracic Surgery, Tokyo Metropolitan Hiroo Hospital.
8
Department of Radiology, Keio University School of Medicine.

Abstract

To evaluate the outcomes and feasibility of stereotactic body radiotherapy (SBRT) for cT3 and cT4N0M0 non-small cell lung cancer (NSCLC), 25 patients with localized primary NSCLC diagnosed as cT3 or cT4N0M0, given SBRT between May 2005 and July 2013, were analyzed. All patients had inoperable tumors. The major reasons for tumors being unresectable were insufficient respiratory function for curative resection, advanced age (>80 years old) or technically inoperable due to invasion into critical organs. The median patient age was 79 years (range; 60-86). The median follow-up duration was 25 months (range: 5-100 months). The 2-year overall survival rates for T3 and T4 were 57% and 69%, respectively. The 2-year local control rates for T3 and T4 were 91% and 68%, respectively. As for toxicities, Grade 0-1, Grade 2 and Grade 3 radiation pneumonitis occurred in 23, 1 and 1 patient, respectively. No other acute or symptomatic late toxicities were reported. Thirteen patients who had no local, mediastinal or intrapulmonary progression at one year after SBRT underwent pulmonary function testing. The median variation in pre-SBRT and post-SBRT forced expiratory volume in 1 s (FEV1) values was -0.1 (-0.8-0.8). This variation was not statistically significant (P = 0.56). Forced vital capacity (FVC), vital capacity (VC), %VC and %FEV1 also showed no significant differences. SBRT for cT3 and cT4N0M0 NSCLC was both effective and feasible. Considering the favorable survival and low morbidity rate, SBRT is a potential treatment option for cT3 and cT4N0M0 NSCLC.

KEYWORDS:

T3N0M0; T4N0M0; inoperable; non–small cell lung cancer; stereotactic body radiotherapy; unresectable

PMID:
26983978
PMCID:
PMC4915546
DOI:
10.1093/jrr/rrw023
[Indexed for MEDLINE]
Free PMC Article

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