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• W2066001496 abstract "To report results for a large pooled cohort of lung SBRT cases treated with daily online CBCT in an era where the preponderance of existing lung SBRT data report on small patient datasets typically without an IGRT requirement. Four hundred eleven patients (434 tumors) received lung SBRT using CBCT-IGRT (Elekta Crawley UK) for Stage I (T1-2N0M0) NSCLC at 1 of 5 institutions from 1998-2009. Median age was 74y (42-92); 53% male, 47% female. Median FEV1 was 1.4L (65% predicted); median DLCO was 11.7 mL/min/mm Hg (53% predicted). 84% of cases were staged with CT and PET. Clinical stage was IA in 68%, IB in 38%, locally recurrent in 1%. Median max tumor dimension was 2.4cm (0.9-8.5cm). 267 tumors were biopsy-proven: 41% adenocarcinoma, 34% squamous, and 25% large cell/mixed/NOS. Eight percent of the patients had synchronous primary tumors. Median volumetric prescription dose (PD) was 54 Gy (20-64 Gy) delivered in median of 3 fractions (fx) (1-15fx) over 8d (1-27d). Median biological equivalent PD (BED10) was 132 Gy (60-180 Gy), corresponding to GTV and PTV mean BED10 doses of 190 Gy (67-309 Gy) and 167 Gy (65-245 Gy). Median ratio for PTV D1/D99 was 1.41. All doses were heterogeneity corrected. Median potential follow-up = 2.2y (0.3-11.8y). Two-year rates of local recurrence (LR), regional recurrence (RR) and distant metastasis (DM) were 8%, 13%, and 26%; 2y overall survival (OS) and cause-specific survival (CSS) were 58% and 84% (p = NS biopsy vs. no biopsy for all endpoints). GTV max dimension (<2.7cm 5% vs. ≥2.7cm 12%, p = 0.01), tumor histology (Adenoca 4%, Squamous 13%, Large cell/mixed/NOS 5%, p = 0.03), and PDBED10 (<105.6 Gy 19% vs. ≥105.6 Gy 5%, p < 0.001) predicted LR. GTV size, lower PDBED10, and squamous histology (borderline) independently predicted for LR. DM rates for PDBED10 <105.6 Gy vs. ≥105.6 Gy were 34% vs. 22%, (p = 0.09); DM was higher for squamous histology (38% vs. 14% adenoca, 25% other, p = 0.007). Presence of a synchronous primary predicted higher RR (22% vs. 11%, p = 0.04) and DM (39% vs. 23%, p < 0.01). Rates of ≥grade 2 pneumonitis, rib fracture, myositis, and dermatitis were 6%, 2%, 1% and 2%. BED3 for Lungs-GTV mean dose was <6.9 Gy vs. ≥6.9 Gy for patients with versus without ≥grade 2 pneumonitis (p = 0.01). In this large dataset of lung SBRT patients receiving CBCT-IGRT, 92% were locally controlled and 58% were alive at 2y. Heterogeneity-corrected volumetric prescription dose BED10 of ≥105.6 Gy, smaller size, and non-squamous histology predicted superior outcomes. Mean lung dose BED3 ≥6.9 Gy predicted grade 2 or higher pneumonitis." @default.
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• W2066001496 date "2010-11-01" @default.
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• W2066001496 title "A Collaborative Analysis of Stereotactic Lung Radiotherapy (Lung SBRT) Outcomes for Stage I Non-small Cell Lung Cancer (NSCLC) using Daily Online Cone-beam CT Image-guided Radiotherapy (CBCT-IGRT)" @default.
• W2066001496 doi "https://doi.org/10.1016/j.ijrobp.2010.07.075" @default.
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