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• W2040555738 abstract "To compare outcomes of patients with clinically versus pathologically diagnosed non-small cell lung cancer (NSCLC) who underwent treatment with stereotactic body radiation therapy (SBRT) in the U.S. A retrospective review of patients treated with SBRT at a single institution for early-stage NSCLC was undertaken, in order to compare outcomes between those with a pathologic diagnosis (PD) and those treated with a clinical diagnosis (without biopsy-confirmation, CD). The programmatic criteria for treating patients without pathology were: a characteristic appearing solitary pulmonary mass between 1 and 5 cm in size that was enlarging on serial CT scans, avid on PET-CT, in a patient with risk factors for lung cancer (smoking history, prior lung malignancy). All patients were discussed, and serial imaging reviewed, at a multidisciplinary conference. A cohort of patients treated after clinical diagnosis was identified, and a cohort of contemporaneous, consecutively treated patients with PD was identified, matched by tumor size and biologically effective dose (BED). Overall survival (OS), progression-free survival (PFS), and local control (LC) were compared using the Kaplan-Meier method. Between January 2008 and December 2011, 170 patients were identified as meeting criteria for analysis. 39 patients were treated with SBRT for CD NSCLC. Of these, 9 (23%) had non-diagnostic biopsies, 4 (10%) refused biopsy, and the remainder (67%) were not referred for EBUS or CT-guided biopsy due to poor baseline pulmonary status. 92 patients treated with SBRT during the same time period for PD NSCLC were identified as matched controls. Median follow-up duration was 13 months for CD, and 10 months for PD. The median tumor size was 2.1 cm in both groups, and both groups received a median BED of 130 Gy (range 80-151 Gy) in 3 to 5 fractions. There was no significant difference in LC (97% CD, 100% PD at 2 years, p=0.5), PFS (median 37 months in both arms, p=0.9), or OS (median 32 months in both arms, p=0.7). Following strict criteria for the clinical diagnosis of NSCLC does not identify a cohort of patients with improved outcomes after SBRT in a U.S. population, suggesting that there are not a substantial number of benign nodules among this group. Further investigation should be undertaken to establish clinical parameters that reliably identify malignancy in high-risk patients, but those who can safely undergo EBUS or CT-guided biopsies should continue to do so." @default.
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• W2040555738 date "2012-11-01" @default.
• W2040555738 modified "2023-09-27" @default.
• W2040555738 title "Stereotactic Body Radiation Therapy for Patients With Clinically Versus Pathologically Diagnosed Non-small Cell Lung Cancer: A Comparative Analysis" @default.
• W2040555738 doi "https://doi.org/10.1016/j.ijrobp.2012.07.1584" @default.
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