Stereotactic body radiotherapy for operable early-stage non-small cell lung cancer

Takahisa Eriguchi, Atsuya Takeda, Naoko Sanuki, Yuichiro Tsurugai, Yousuke Aoki, Yohei Oku, Yu Hara, Takeshi Akiba, Naoyuki Shigematsu

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Purpose To analyze outcomes of stereotactic body radiotherapy (SBRT) for operable patients with early-stage non-small cell lung cancer (NSCLC) and to evaluate factors associated with outcomes. Methods We retrospectively analyzed operable patients with NSCLC, staged as cT1-2N0M0, treated with SBRT between 2006 and 2015. Both biopsy-proven and clinically diagnosed NSCLC were included. Local control and survival rates were calculated and compared between subsets of patients. We investigated factors associated with outcomes. Results We identified 88 operable patients among 661 patients with cT1-2N0M0 NSCLC. The median age was 79 years (range: 55–88). The median follow-up time after SBRT was 40 months (range: 4–121). Fifty-nine patients had been pathologically diagnosed and the other 29 had been clinically diagnosed as having NSCLC. Local control, cause-specific survival (CSS) and overall survival (OS) at 3 years were 91%, 97% and 90% for T1, and 100%, 82% and 74% for T2, respectively. The CSS and OS at 3 years were 100% and 100% for GGO and 83% and 59% for solid tumors, respectively (p = 0.005). On univariate analysis, age and T stage were significantly associated with CSS, and age, the Charlson Comorbidity Index (CCI), and opacity were significantly associated with OS. On multivariate analysis, age and CCI were significantly associated with OS. As for toxicities, Grades 0, 1, 2 and 3 radiation pneumonitis occurred in 37.5%, 47.7%, 13.6% and 1.1% of patients, respectively. No Grade 4 or 5 radiation pneumonitis occurred, and no other toxicities of Grade 2 or above were observed. Conclusion Outcomes of SBRT for operable early stage NSCLC were as good as previous SBRT and surgery studies. Further investigation for selecting good SBRT candidates is warranted in high-risk operable patients.

Original languageEnglish
Pages (from-to)62-67
Number of pages6
JournalLung Cancer
Volume109
DOIs
Publication statusPublished - 2017 Jul 1

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Radiosurgery
Non-Small Cell Lung Carcinoma
Survival
Radiation Pneumonitis
Comorbidity
Multivariate Analysis
Survival Rate
Biopsy

Keywords

  • Non-small cell lung cancer
  • Operable
  • SBRT
  • Shared decision making

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine
  • Cancer Research

Cite this

Stereotactic body radiotherapy for operable early-stage non-small cell lung cancer. / Eriguchi, Takahisa; Takeda, Atsuya; Sanuki, Naoko; Tsurugai, Yuichiro; Aoki, Yousuke; Oku, Yohei; Hara, Yu; Akiba, Takeshi; Shigematsu, Naoyuki.

In: Lung Cancer, Vol. 109, 01.07.2017, p. 62-67.

Research output: Contribution to journalArticle

Eriguchi, T, Takeda, A, Sanuki, N, Tsurugai, Y, Aoki, Y, Oku, Y, Hara, Y, Akiba, T & Shigematsu, N 2017, 'Stereotactic body radiotherapy for operable early-stage non-small cell lung cancer', Lung Cancer, vol. 109, pp. 62-67. https://doi.org/10.1016/j.lungcan.2017.04.022
Eriguchi, Takahisa ; Takeda, Atsuya ; Sanuki, Naoko ; Tsurugai, Yuichiro ; Aoki, Yousuke ; Oku, Yohei ; Hara, Yu ; Akiba, Takeshi ; Shigematsu, Naoyuki. / Stereotactic body radiotherapy for operable early-stage non-small cell lung cancer. In: Lung Cancer. 2017 ; Vol. 109. pp. 62-67.
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abstract = "Purpose To analyze outcomes of stereotactic body radiotherapy (SBRT) for operable patients with early-stage non-small cell lung cancer (NSCLC) and to evaluate factors associated with outcomes. Methods We retrospectively analyzed operable patients with NSCLC, staged as cT1-2N0M0, treated with SBRT between 2006 and 2015. Both biopsy-proven and clinically diagnosed NSCLC were included. Local control and survival rates were calculated and compared between subsets of patients. We investigated factors associated with outcomes. Results We identified 88 operable patients among 661 patients with cT1-2N0M0 NSCLC. The median age was 79 years (range: 55–88). The median follow-up time after SBRT was 40 months (range: 4–121). Fifty-nine patients had been pathologically diagnosed and the other 29 had been clinically diagnosed as having NSCLC. Local control, cause-specific survival (CSS) and overall survival (OS) at 3 years were 91{\%}, 97{\%} and 90{\%} for T1, and 100{\%}, 82{\%} and 74{\%} for T2, respectively. The CSS and OS at 3 years were 100{\%} and 100{\%} for GGO and 83{\%} and 59{\%} for solid tumors, respectively (p = 0.005). On univariate analysis, age and T stage were significantly associated with CSS, and age, the Charlson Comorbidity Index (CCI), and opacity were significantly associated with OS. On multivariate analysis, age and CCI were significantly associated with OS. As for toxicities, Grades 0, 1, 2 and 3 radiation pneumonitis occurred in 37.5{\%}, 47.7{\%}, 13.6{\%} and 1.1{\%} of patients, respectively. No Grade 4 or 5 radiation pneumonitis occurred, and no other toxicities of Grade 2 or above were observed. Conclusion Outcomes of SBRT for operable early stage NSCLC were as good as previous SBRT and surgery studies. Further investigation for selecting good SBRT candidates is warranted in high-risk operable patients.",
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AU - Eriguchi, Takahisa

AU - Takeda, Atsuya

AU - Sanuki, Naoko

AU - Tsurugai, Yuichiro

AU - Aoki, Yousuke

AU - Oku, Yohei

AU - Hara, Yu

AU - Akiba, Takeshi

AU - Shigematsu, Naoyuki

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N2 - Purpose To analyze outcomes of stereotactic body radiotherapy (SBRT) for operable patients with early-stage non-small cell lung cancer (NSCLC) and to evaluate factors associated with outcomes. Methods We retrospectively analyzed operable patients with NSCLC, staged as cT1-2N0M0, treated with SBRT between 2006 and 2015. Both biopsy-proven and clinically diagnosed NSCLC were included. Local control and survival rates were calculated and compared between subsets of patients. We investigated factors associated with outcomes. Results We identified 88 operable patients among 661 patients with cT1-2N0M0 NSCLC. The median age was 79 years (range: 55–88). The median follow-up time after SBRT was 40 months (range: 4–121). Fifty-nine patients had been pathologically diagnosed and the other 29 had been clinically diagnosed as having NSCLC. Local control, cause-specific survival (CSS) and overall survival (OS) at 3 years were 91%, 97% and 90% for T1, and 100%, 82% and 74% for T2, respectively. The CSS and OS at 3 years were 100% and 100% for GGO and 83% and 59% for solid tumors, respectively (p = 0.005). On univariate analysis, age and T stage were significantly associated with CSS, and age, the Charlson Comorbidity Index (CCI), and opacity were significantly associated with OS. On multivariate analysis, age and CCI were significantly associated with OS. As for toxicities, Grades 0, 1, 2 and 3 radiation pneumonitis occurred in 37.5%, 47.7%, 13.6% and 1.1% of patients, respectively. No Grade 4 or 5 radiation pneumonitis occurred, and no other toxicities of Grade 2 or above were observed. Conclusion Outcomes of SBRT for operable early stage NSCLC were as good as previous SBRT and surgery studies. Further investigation for selecting good SBRT candidates is warranted in high-risk operable patients.

AB - Purpose To analyze outcomes of stereotactic body radiotherapy (SBRT) for operable patients with early-stage non-small cell lung cancer (NSCLC) and to evaluate factors associated with outcomes. Methods We retrospectively analyzed operable patients with NSCLC, staged as cT1-2N0M0, treated with SBRT between 2006 and 2015. Both biopsy-proven and clinically diagnosed NSCLC were included. Local control and survival rates were calculated and compared between subsets of patients. We investigated factors associated with outcomes. Results We identified 88 operable patients among 661 patients with cT1-2N0M0 NSCLC. The median age was 79 years (range: 55–88). The median follow-up time after SBRT was 40 months (range: 4–121). Fifty-nine patients had been pathologically diagnosed and the other 29 had been clinically diagnosed as having NSCLC. Local control, cause-specific survival (CSS) and overall survival (OS) at 3 years were 91%, 97% and 90% for T1, and 100%, 82% and 74% for T2, respectively. The CSS and OS at 3 years were 100% and 100% for GGO and 83% and 59% for solid tumors, respectively (p = 0.005). On univariate analysis, age and T stage were significantly associated with CSS, and age, the Charlson Comorbidity Index (CCI), and opacity were significantly associated with OS. On multivariate analysis, age and CCI were significantly associated with OS. As for toxicities, Grades 0, 1, 2 and 3 radiation pneumonitis occurred in 37.5%, 47.7%, 13.6% and 1.1% of patients, respectively. No Grade 4 or 5 radiation pneumonitis occurred, and no other toxicities of Grade 2 or above were observed. Conclusion Outcomes of SBRT for operable early stage NSCLC were as good as previous SBRT and surgery studies. Further investigation for selecting good SBRT candidates is warranted in high-risk operable patients.

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