Abstract
Purpose/Objective(s): Stereotactic body radiation therapy (SBRT) has been shown to have increased local control and overall survival relative to conventional external beam radiation therapy in patients with medically inoperable stage I non-small cell lung cancer (NSCLC). Excellent rates of local control have been demonstrated both in clinical trials and in single-center studies at large academic institutions. However, there is limited data on the experiences of small academic hospitals with SBRT for stage I NSCLC. The purpose of this study is to report the local control and overall survival rates in patients treated with SBRT for stage I NSCLC at Winthrop-University Hospital (WUH), a small academic hospital.Materials/Methods: This is a retrospective review of 78 stage I central and peripheral NSCLC tumors treated between December 2006 and July 2012 with SBRT at WUH. Treatment was given utilizing fiducials and a respiratory tracking system. If the fiducials were not trackable, a spine tracking system was used for tumor localization. CT-based planning was performed using the ray trace algorithm. Treatment was delivered over consecutive days to a median dose of 4800 cGy delivered in four fractions. The Kaplan–Meier method was used to calculate local control and overall survival.Results: The median age was 78.5 years. Fifty-four percent of the patient population was female. Sixty seven percent of the tumors were stage IA, and 33% of the tumors were stage IB. Fifty-three percent of the tumors were adenocarcinomas and 29% were squamous cell carcinomas, with the remainder being of unknown histology or NSCLC, not otherwise specified The 2-year local control rate was 87%, and the 2-year overall survival was 68%.Conclusion: Our findings support that local control and overall survival at a small academic hospital are comparable to that of larger academic institutions’ published experiences with SBRT for stage I NSCLC.
Highlights
Our findings support that local control and overall survival at a small academic hospital are comparable to that of larger academic institutions’ published experiences with Stereotactic body radiation therapy (SBRT) for stage I non-small cell lung cancer (NSCLC)
Surgery is the standard of care for stage I non-small cell lung cancer (NSCLC) [1] with local recurrence rates quoted around 5% [2, 3] and 5-year overall survival from 75 to 80% [4]
The goal of this paper is to report the local recurrence rate and overall survival of patients with stage I NSCLC treated with SBRT at our institution
Summary
Surgery is the standard of care for stage I non-small cell lung cancer (NSCLC) [1] with local recurrence rates quoted around 5% [2, 3] and 5-year overall survival from 75 to 80% [4]. Local control with conventional radiation therapy is reported from 40 to 70% with 5-year overall survival quoted from 7 to 32% [5]. SBRT has been shown to be superior to conventional radiation therapy with local control from 83 to 93% and 3-year overall survival from 47 to 84.7% [4, 6,7,8,9,10]. The goal of this paper is to report the local recurrence rate and overall survival of patients with stage I NSCLC treated with SBRT at our institution. This study performs an analysis of the patient, tumor, and treatment characteristics that predict local control and overall survival
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