Radiothérapie en conditions stéréotaxiques dans les cancers bronchiques de stades I et II : résultats d’une série de 33 patients

Abstract

Purpose Surgery is the main treatment of early stage non small cell lung cancer. However, in inoperable patients, the treatment is usually conventional radiotherapy. Results are poor and acute toxicity is severe. Stereotactic body radiation therapy provides better results in terms of local control and toxicity. Our purpose was to evaluate the clinical outcomes of patients with primary lung tumours treated by stereotactic body radiation therapy using a stereotactic body frame at the Orléans Regional Hospital. Patients and methods Between June 2000 and December 2007, 33 patients with stage I and II non small cell lung cancer were treated by stereotactic body radiation therapy. Breathing control was obtained by passive diaphragm control. Two CT-scans were performed 1 week apart to determine the accuracy of patient repositioning and define target volumes. Five or six fields were set up to achieve a conformal dose distribution. According to tumour size, a total of 50 or 40 Gy was delivered in 10 fractions. Results Mean patient age was 70 years. Median follow-up was 25 months. Ten patients with a complete response are still alive. Eight patients have died from local progression, eight from metastasis, and six from comorbidity. Median disease-free survival was 22.6 months. No acute toxicity up to grade II (CTC AE 3.0) was observed. None of the patients still alive has developed any complications. Conclusion In patients who cannot undergo radical surgery, stereotactic body radiation therapy using a sterotactic body frame is well-tolerated and seems to be an efficient treatment method.