P3.16-14 SBRT in Early Stages of Lung Cancer

Abstract

We present the experience in our department with SBRT in early stages of lung cancer. Between April 2012 and January 2018, 59 patients with 65 different locations underwent to SBRT in early stages of lung cancer (51 men and 8 woman, with a median age of 76 years). 44 patients had histological confirmation (22 adenocarcinomas, 13 squamous cell carcinomas, 1 adenosquamous and 1 typical carcinoid). There was not histological confirmation in 15 patients. In all patients, PET-CT was used for the diagnosis. The T-stage classification (8th Edition of the TNM Classification), was the following: T1a (6), T1b (24), T1c (16), T2a (10), T2b (6), T3 (3). The treatment planning was made using vacuum body fixation and abdominal compression to reduce intrafractional organ motion. We made five CTs planning in all patients: 3 free breathing, inhalation and exhalation. The internal target volume (ITV) was delineated based on the fusion of five CTs. The planning target volume (PTV) was determined an adding additional setup margin to ITV. We made different fraction schemes, and the most used were 5x1200 cGy and 8x750 cGy. The assessment of response was performed with CT and/or PET-CT. With a median follow up of 24 months, the local control was 88%, with an overall survival of 76%. The tolerance to treatment was excellent, appearing as acute toxicity, rib pain (G1-G2) in 4 patients, asthenia (G1) in 3 patients, and as chronic toxicity, costal fracture in one patient. The local control obtained in early stages of lung cancer treated with SBRT in our series is high, with an excellent clinical tolerance.