DOSE-RESPONSE FOR STEREOTACTIC BODY RADIOTHERAPY IN EARLY-STAGE NON-SMALL-CELL LUNG CANCER

作者：Olsen Jeffrey R; Robinson Clifford G; El Naqa Issam; Creach Kimberly M; Drzymala Robert E; Bloch Charles; Parikh Parag J; Bradley Jeffrey D^*

来源：International Journal of Radiation Oncology, Biology, Physics, 2011, 81(4): E299-E303.

DOI：10.1016/j.ijrobp.2011.01.038

• Lung
• Cancer
• NSCLC
• SBRT
• Stereotactic

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 x 3 fractions for peripheral tumors (n = 111) and either 9 Gy x 5 fractions (n = 8) or 10 Gy x 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 x 5, 10 Gy x 5, and 18 Gy x 3 groups, respectively. Local control statistics for Years 1 and 2 were, respectively, 75% and 50% for 9 Gy x 5, 100% and 100% for 10 Gy x 5, and 99% and 91% for 18 Gy x 3. Median overall survival was 14 months, not reached, and 34 months for the 9 Gy x 5, 10 Gy x 5, and 18 Gy x 3 treatments, respectively. No difference in local control or overall survival was found between the 10 Gy x 5 and 18 Gy x 3 groups on log-rank test, but both groups had improved local control and overall survival compared with 9 Gy x 5. Treatment with 9 Gy x 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 x 5 and 18 Gy x 3 seem to be efficacious for lung cancer SBRT and provide superior local control and overall survival compared with 9 Gy x 5.

• 出版日期2011-11-15