The clinical analysis of stereotactic ablative radiotherapy for stage I peripheral non-small cell lung cancers

Abstract

Objective To investigate the efficacy and toxicity of stereotactic ablative radiotherapy for stage I peripheral non-small cell lung cancers. Methods Thirty six patients of stage I peripheral non-small cell lung cancers were treated with stereotactic ablative radiotherapy. The prescription dose was 12 Gy per fraction×4 fraction in one to two weeks. The 100% planning target volume (PTV) was covered by the isodose curve of 95% prescription dose. Organs at risk and their respective tolerance doses used during treatment planning were developed from the research scheme of the Radiation Therapy Oncology Group 0236. Before the radiation delivery, all patients were scanned by the fan beam CT or the cone beam CT for image guidance and registration. The follow-up for the patients was given to observe the toxicity and efficacy of stereotactic ablative radiotherapy (SABR). Results The median follow-up time was 18.7 months (range of 4 to 36 months). After treatment, the overall response rate was 88.9%, with complete response (CR) 17 cases(47.2%), partial response (PR) 15 cases(41.7%), and stable disease (SD) 4 cases(11.1%). The estimated overall survival rate at 1 and 3 years was 92.3% (95% confidence interval [CI], 86.3%~97.1%) and 85.3% (95% CI, 80.5%~90.6%). The estimated local control rate at 3 years was 90.2% (95% CI, 85.7%~94.8%). There was no grade Ⅲ or above toxicity related to treatment. Conclusions The stereotactic ablative radiotherapy attains good local control and survival efficacy for the stage I peripheral non-small lung cancer patients. It is well tolerated owing to low toxicity. Key words: Carcinoma, non-small-cell lung/RT; Catheter ablation/MT; Radiosurgery/MT