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• W3205279675 abstract "Stereotactic body radiotherapy (SBRT) has proven to be an effective modality for medically inoperable early-stage non-small cell lung cancer (ES-NSCLC) and pulmonary metastases. However, the concern remains of its effect on pulmonary function test parameters especially in patients with chronic obstructive pulmonary disease (COPD). In this retrospective study, PFT data was evaluated for consecutively treated SBRT patients. PFT was done for all patients (unless unable to perform) at baseline and at 3-and 6-month. Baseline and post treatment PFTs at 3 and 6 months were compared and graded according to the SBRT pulmonary toxicity scale. PFT changes were also analysed according to the COPD status as defined by GOLD’S criteria. All patients underwent pulmonary rehabilitation before SBRT treatment. All patients received SBRT dose ranging from 48-60 Gy in 5-10 fractions depending upon their location. A total of 95 patients (73 - ES-NSCLC and 22 - metastases) treated from 2010 to 2019 were included in this study. Median age was 64 years (range, 23-88), 67 - male and 39 smokers. Twenty-seven patients (28%) had baseline COPD, out of which 9 had severe and 4 had very severe COPD. Approximately 1/3rd of the patients were medically inoperable due to poor baseline PFT parameters. Baseline, 3- and 6-month PFT was available for 70, 20 and 7 patients, respectively. Baseline median forced expiratory volume in 1 second (FEV1) was 1.3 litres (range, 0.5-3.1litres) and predicted FEV1 was 64% (17%-121%), respectively. Baseline median corrected diffusion capacity for carbon monoxide (DLCO) was 6.8 mmol/min/kPa (2.3-9.9) and predicted was 72% (32-112). Baseline median forced vital capacity (FVC) was 2.1 (0.5-3.7) and predicted was 70% (22%-135%). Among evaluable patients at 3 months, there was no significant decline in median FEV1 (1.6 to 1.6 litre) and FVC (median 2.4 to 2.2 litre). Median DLCO declined from 6.6 to 5.7 and predicted from 83% to 78%. According to SBRT scale, grade 1-2 toxicity in FEV1 and FVC was seen in 9 (33.3%) and 5 (20%) patients respectively. There were no ≥ grade 3 toxicities in FEV1 and FVC. DLCO grade 1-2 toxicity was seen in 4 (21%) patients, grade 3 was seen in 1 patient. Of COPD patients, median FEV1 declined from 1.1 to 1 (10%), no change in FVC and DLCO declined from 5.5 to 4.8 (13%), respectively. Only one patient worsened in COPD grade from severe to very severe. Amongst patients who had significant drop (>10%) in FEV1 ( n=3), 1 patient had baseline severe and 2 had baseline moderate COPD. SBRT treatment did not cause any significant decline in FEV1 and FVC, however, approximate 10-15% decline was seen in DLCO. SBRT is also safe in patients with severe and very severe COPD." @default.
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• W3205279675 date "2021-10-01" @default.
• W3205279675 modified "2023-09-26" @default.
• W3205279675 title "P05.05 Impact of Lung Stereotactic Body Radiotherapy on Pulmonary Function Test – Experience from Tertiary Cancer Centre in India" @default.
• W3205279675 doi "https://doi.org/10.1016/j.jtho.2021.08.277" @default.
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