Outcomes after stereotactic body radiotherapy for lung tumors, with emphasis on comparison of primary lung cancer and metastatic lung tumors.

Takaya Yamamoto,Yoshihiro Takai,Noriyoshi Takahashi,Masashi Koto,Haruo Matsushita,Ken Takeda,Youjirou Ishikawa,Rei Umezawa,Yuko Shirata,Keiko Abe,Masaki Kubozono,Noriyuki Kadoya,Toshiyuki Sugawara,Maiko Kozumi,Keiichi Jingu

doi:10.1186/1471-2407-14-464

Takaya Yamamoto, Yoshihiro Takai + Show 13 more

Open Access

https://doi.org/10.1186/1471-2407-14-464

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Journal: BMC cancer	Publication Date: Jun 23, 2014
Citations: 57	License type: cc-by

Affiliation: Hirosaki University, Tohoku University

Abstract

BackgroundThe goal of this study was to determine the prognostic factors associated with an improved overall outcome after stereotactic body radiotherapy (SBRT) for primary lung cancer and metastatic lung tumors.MethodsA total of 229 lung tumors in 201 patients were included in the study. SBRT of 45 Gy in 3 fractions, 48 Gy in 4 fractions, 60 Gy in 8 fractions or 60 Gy in 15 fractions was typically used to treat 172 primary lungs cancer in 164 patients and 57 metastatic lung tumors in 37 patients between January 2001 and December 2011. Prognostic factors for local control (LC) and overall survival (OS) were analyzed using a Cox proportional hazards model.ResultsThe median biologically effective dose was 105.6 Gy based on alpha/beta = 10 (BED10). The median follow-up period was 41.9 months. The 3-year LC and OS rates were 72.5% and 60.9%, and the 5-year LC and OS rates were 67.8% and 38.1%, respectively. Radiation pneumonitis of grades 2, 3 and 5 occurred in 22 petients, 6 patients and 1 patient, respectively. Multivariate analyses revealed that tumor origin (primary lung cancer or metastatic lung tumor, p < 0.001), tumor diameter (p = 0.005), BED10 (p = 0.029) and date of treatment (p = 0.011) were significant independent predictors for LC and that gender (p = 0.012), tumor origin (p = 0.001) and tumor diameter (p < 0.001) were significant independent predictors for OS.ConclusionsSBRT resulted in good LC and tolerable treatment-related toxicities. Tumor origin and tumor diameter are significant independent predictors for both overall survival and local control.

Highlights

The goal of this study was to determine the prognostic factors associated with an improved overall outcome after stereotactic body radiotherapy (SBRT) for primary lung cancer and metastatic lung tumors
We retrospectively reviewed our results for lung tumors treated with SBRT with the goal of identifying prognostic factors associated with local control (LC) and overall survival (OS) and establishing a strategy for balancing the benefits and risks in use of SBRT
Tumor origin, tumor diameter and prescription dose (BED10: > 105 Gy vs. ≤ 105 Gy; p = 0.029, Hazard ratio (HR): 0.51, 95% Confidence interval (CI): 0.27-0.93) were significant independent predictors for LC; and gender, tumor origin and tumor diameter were significant independent predictors for OS

Summary

Introduction

The goal of this study was to determine the prognostic factors associated with an improved overall outcome after stereotactic body radiotherapy (SBRT) for primary lung cancer and metastatic lung tumors. Stereotactic body radiotherapy (SBRT) results in a high local control rate for relatively small lung tumors and has low treatment-related toxicity, and it has many benefits for patients, especially patients who cannot undergo surgery [1,2,3]. If SBRT has an efficacy comparable to that of tumor resection, this technique may provide patients with a better quality of life, shorter time away from work, and minimal interruption of other treatment. This third issue may be a major advantage because systemic chemotherapy is often performed for targeting oligometastatic lung tumors, treating another lesion, or as maintenance or consolidation therapy for potential metastases. SBRT for lung oligo-recurrence with good LC rate and survival rate has been reported [7]

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