In Regard to Nantavithya et al

Abstract

To the Editor: We read the interesting results from a phase 2 randomized study comparing the toxicity and efficacy of stereotactic body proton therapy (SBPT) and stereotactic body radiation therapy (SBRT) for high-risk medically inoperable early-stage non-small cell lung cancer (NSCLC) by Nantavithya et al ( 1 Nantavithya C. Gomez D.R. Wei X. et al. A phase II study of stereotactic body radiotherapy and stereotactic body proton therapy for high-risk medically inoperable early-stage non-small cell lung cancer. Int J Radiat Oncol Biol Phys. 2018; 101: 558-563 Google Scholar ). Although their study was closed early because of poor accrual and insurance issues, a total of 19 patients receiving 50 Gy (relative biologic effectiveness) in 4 fractions were included for analysis. With a median follow-up of 32 months, the 3-year overall survival (OS) rates were 27.8% and 90%, the 3-year local control (LC) rates were 87.5% and 90.0% in SBRT and SBPT arms, respectively. The study showed significant improvements in both LC and OS in the SBPT arm. Phase 2 Study of Stereotactic Body Radiation Therapy and Stereotactic Body Proton Therapy for High-Risk, Medically Inoperable, Early-Stage Non-Small Cell Lung CancerInternational Journal of Radiation Oncology, Biology, PhysicsVol. 101Issue 3PreviewTo report the feasibility of conducting a randomized study to compare the toxicity and efficacy of stereotactic body radiation therapy (SBRT) versus stereotactic body proton therapy (SBPT) for high-risk, medically inoperable, early-stage non-small cell lung cancer (NSCLC). Full-Text PDF In Reply to Hurmuz and OzyigitInternational Journal of Radiation Oncology, Biology, PhysicsVol. 101Issue 3PreviewTo the Editor: We thank Dr Hurmuz for expressing interest in our recent report (1) and her cogent comments (2). Stereotactic body radiation therapy (SBRT) has indeed become a standard treatment for peripherally located, medically inoperable stage I non-small cell lung cancer (NSCLC). Local control rates from SBRT for such patients have generally been >90%, with regional lymph node control rates ranging from 85% to 90% (3, 4). Our previous pooled analysis of the STARS and ROSEL randomized studies (3) revealed estimated rates of locoregional control and overall survival (OS) at 3 years of 90% and 95% in the SBRT arms—indeed, the OS rates were better for SBRT than for surgery (79%). Full-Text PDF