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• W2090456905 abstract "SBRT is becoming a standard treatment for patients with stage I NSCLC who are inoperable or refuse surgery. We started SBRT in July 2006 using the system equipped with micro-multi-leaf collimators and an accurate patient setup system. In this study, clinical results of SBRT for stage I NSCLC were analyzed based on the new TNM classification (UICC 7th) and with special reference to difference between adenocarcinoma (AD) and squamous cell carcinoma (SCC). Enrolled were 105 patients with NSCLC (78 men and 27 women) with a median age of 78 years (range, 55- 89); 57 patients had stage IA (T1a, 13; T1b, 44) cancer and 48 had stage IB (T2a). Ninety-one lesions were histologically confirmed; 51 were AD, 31 were SCC, and 9 were NSCLC. Most cases were inoperable because of chronic lung or other diseases, or high age. The CTV was delineated using CT images taken at 3 phases (expiratory, inspiratory and free breathing). The PTV margin was 5-7 mm. Three coplanar and 4 non-coplanar beams were used. The PTV was covered with 95% or higher isodose lines. Median PTV volume was 43.4 cc (range, 14-108 cc). The standard SBRT dose was 48-50 Gy in 4 fractions over 2 weeks for tumors up to 3 cm in diameter and 52 Gy in 4 fractions in 2 weeks for larger ones. Ten patients were treated with 56-64 Gy in 8 fractions because of proximity to the major risk organs or central location of the tumor. The median follow-up period was 38 months (range, 15-64) for living patients. The 3-year survival rate was 64% for stage IA patients and 41% for stage IB (p=0.004). The 3-year cause-specific survival rate was 85% and 78%, respectively. The 3-year local control rate was 96% for stage IA and 80% for stage IB (p=0.008) and the progression-free rate was 74% and 46%, respectively (p=0.01). No significant differences were noted in any of these rates between T1a and T1b tumors. The 3-year local control rate was 100% for T1a and 95% for T1b. In stage IB patients, the 3-year distant metastasis-free rate was significantly lower in AD than SCC patients (45% vs 81%, p=0.05), while the other rates did not differ significantly. The 3-year survival and local control rates were 55% and 90%, respectively, for patients undergoing 4-fraction SBRT and 47% and 86%, respectively, for those receiving 8-fraction treatment, with no significant difference. Grade 1 and 2 radiation pneumonitis developed in 43% and 15% of the patients, respectively. SBRT is safe and efficient for stage I NSCLC. Stage IB patients had lower survival and local control rates than stage IA patients, but there were no differences between T1a and T1b patients. Stage IB AD patients may require adjuvant chemotherapy in light of the high rate of distant metastasis." @default.
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• W2090456905 date "2012-11-01" @default.
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• W2090456905 title "Stereotactic Body Radiation Therapy (SBRT) for Stage I Non-small Cell Lung Cancer (NSCLC): Analysis Based on the New TNM Classification and Difference Due to Histology" @default.
• W2090456905 doi "https://doi.org/10.1016/j.ijrobp.2012.07.1471" @default.
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