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. 2024 Sep 25;6(1):tzae028.
doi: 10.1093/bjro/tzae028. eCollection 2024 Jan.

Patient, tumour, and dosimetric factors influencing survival in non-small cell lung cancer patients treated with stereotactic ablative body radiotherapy

Minal Padden-Modi  1 , Yevhen Spivak  1 , Ian Gleeson  2 , Andrew Robinson  2 , Kamalram Thippu Jayaprakash  1
Affiliations

Patient, tumour, and dosimetric factors influencing survival in non-small cell lung cancer patients treated with stereotactic ablative body radiotherapy

Minal Padden-Modi et al. BJR Open. .

Abstract

Objectives: We aimed to analyse clinical outcomes of peripheral, early-stage non-small cell lung cancer (NSCLC) patients treated with stereotactic ablative body radiotherapy (SABR), and evaluate potential patient, tumour, and dosimetric variables influencing survival.

Methods: Data were collected retrospectively from patients treated between September 2012 and December 2016 and followed up until January 2021. Patient demographics, tumour characteristics, SABR dosimetric parameters, and survival data were collected from electronic patient medical records. Descriptive statistics were performed, and SPSS software was used for survival analysis.

Results: Eighty-nine patients were included of whom 49.5% were male and 50.5% female. Median age was 74 years. 98.8% of patients had T1-2 tumours and 89.9% underwent 55 Gy in 5 fractions. Median overall survival time was 58.7 months. On uni- and multi-variate analysis, neither patient nor tumour variables showed association with overall survival. However, planning target volume (PTV) and minimum dose to PTV correlated with overall survival. There was a signal for association between mean lung dose and overall survival on multivariate analysis.

Conclusions: Our long-term results show SABR is an effective treatment for peripheral, early-stage NSCLC with excellent overall survival, comparable to other series. Our study found only the PTV and minimum dose to PTV had an impact on overall survival, which demonstrates the importance of generating optimal SABR plans.

Advances in knowledge: Our work identified lung SABR dosimetric parameters that correlate with survival, which illustrates the importance of producing optimal lung SABR plans.

Keywords: non-small cell lung cancer; stereotactic ablative body radiotherapy; survival.

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Conflict of interest statement

K.T.J. is an Assistant Editor for Clinical Oncology.

Figures

Figure 1.
Figure 1.
Example SABR plan shown in radiation dose gradient. Organs at Risk (OAR) shown are lungs, spinal cord, oesophagus, and proximal airways. The dose prescription used was 55 Gy/5#.
Figure 2.
Figure 2.
Overall survival, Kaplan–Meier survival analysis.
See this image and copyright information in PMC

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