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. 2014 Oct 20:4:287.
doi: 10.3389/fonc.2014.00287. eCollection 2014.

Stereotactic body radiation therapy for stage I non-small cell lung cancer: a small academic hospital experience

Oren B Factor  1 , Charles C Vu  2 , Jeffrey G Schneider  3 , Matthew R Witten  4 , Scott L Schubach  5 , Alicia E Gittleman  4 , Donna T Catell  4 , Jonathan A Haas  4
Affiliations

Stereotactic body radiation therapy for stage I non-small cell lung cancer: a small academic hospital experience

Oren B Factor et al. Front Oncol. .

Abstract

Purpose/objective(s): Stereotactic body radiation therapy (SBRT) has been shown to have increased local control and overall survival relative to conventional external beam radiation therapy in patients with medically inoperable stage I non-small cell lung cancer (NSCLC). Excellent rates of local control have been demonstrated both in clinical trials and in single-center studies at large academic institutions. However, there is limited data on the experiences of small academic hospitals with SBRT for stage I NSCLC. The purpose of this study is to report the local control and overall survival rates in patients treated with SBRT for stage I NSCLC at Winthrop-University Hospital (WUH), a small academic hospital.

Materials/methods: This is a retrospective review of 78 stage I central and peripheral NSCLC tumors treated between December 2006 and July 2012 with SBRT at WUH. Treatment was given utilizing fiducials and a respiratory tracking system. If the fiducials were not trackable, a spine tracking system was used for tumor localization. CT-based planning was performed using the ray trace algorithm. Treatment was delivered over consecutive days to a median dose of 4800 cGy delivered in four fractions. The Kaplan-Meier method was used to calculate local control and overall survival.

Results: The median age was 78.5 years. Fifty-four percent of the patient population was female. Sixty seven percent of the tumors were stage IA, and 33% of the tumors were stage IB. Fifty-three percent of the tumors were adenocarcinomas and 29% were squamous cell carcinomas, with the remainder being of unknown histology or NSCLC, not otherwise specified The 2-year local control rate was 87%, and the 2-year overall survival was 68%.

Conclusion: Our findings support that local control and overall survival at a small academic hospital are comparable to that of larger academic institutions' published experiences with SBRT for stage I NSCLC.

Keywords: CyberKnife; SABR; SBRT; local control; non-small cell lung cancer; overall survival.

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Figures

Figure 1
Figure 1
Kaplan–Meier curve for local control. The median follow-up for local control was 14.4 months. A total of seven local failures occurred in this study. The median time to local failure was 17 months with a range from 5 to 53 months. The 2-year local control rate was 87%.
Figure 2
Figure 2
Kaplan–Meier curve for overall survival. Median follow-up for overall survival was 18.8 months. The 2-year overall survival was 68% in this patient population.
Figure 3
Figure 3
Kaplan–Meier curve for recurrence-free survival. There were 25 cases of recurrence of any form. The 2-year recurrence-free survival was 48.3%.
See this image and copyright information in PMC

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