Stereotactic Body Radiotherapy for Primary Lung Cancer at a Dose of 50 Gy Total in Five Fractions to the Periphery of the Planning Target Volume Calculated Using a Superposition Algorithm

Atsuya Takeda, Naoko Sanuki, Etsuo Kunieda, Toshio Ohashi, Yohei Oku, Toshiaki Takeda, Naoyuki Shigematsu, Atsushi Kubo

Research output: Contribution to journalArticle

87 Citations (Scopus)

Abstract

Purpose: To retrospectively analyze the clinical outcomes of stereotactic body radiotherapy (SBRT) for patients with Stages 1A and 1B non-small-cell lung cancer. Methods and Materials: We reviewed the records of patients with non-small-cell lung cancer treated with curative intent between Dec 2001 and May 2007. All patients had histopathologically or cytologically confirmed disease, increased levels of tumor markers, and/or positive findings on fluorodeoxyglucose positron emission tomography. Staging studies identified their disease as Stage 1A or 1B. Performance status was 2 or less according to World Health Organization guidelines in all cases. The prescribed dose of 50 Gy total in five fractions, calculated by using a superposition algorithm, was defined for the periphery of the planning target volume. Results: One hundred twenty-one patients underwent SBRT during the study period, and 63 were eligible for this analysis. Thirty-eight patients had Stage 1A (T1N0M0) and 25 had Stage 1B (T2N0M0). Forty-nine patients were not appropriate candidates for surgery because of chronic pulmonary disease. Median follow-up of these 49 patients was 31 months (range, 10-72 months). The 3-year local control, disease-free, and overall survival rates in patients with Stages 1A and 1B were 93% and 96% (p = 0.86), 76% and 77% (p = 0.83), and 90% and 63% (p = 0.09), respectively. No acute toxicity was observed. Grade 2 or higher radiation pneumonitis was experienced by 3 patients, and 1 of them had fatal bacterial pneumonia. Conclusions: The SBRT at 50 Gy total in five fractions to the periphery of the planning target volume calculated by using a superposition algorithm is feasible. High local control rates were achieved for both T2 and T1 tumors.

Original languageEnglish
Pages (from-to)442-448
Number of pages7
JournalInternational Journal of Radiation Oncology Biology Physics
Volume73
Issue number2
DOIs
Publication statusPublished - 2009 Feb 1

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Radiosurgery
lungs
planning
radiation therapy
Lung Neoplasms
cancer
dosage
Non-Small Cell Lung Carcinoma
tumors
Radiation Pneumonitis
pneumonia
Bacterial Pneumonia
Tumor Biomarkers
surgery
toxicity
Positron-Emission Tomography
markers
Lung Diseases
Disease-Free Survival
health

Keywords

  • Lung cancer
  • Stereotactic body radiotherapy
  • Superposition algorithm

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation
  • Cancer Research

Cite this

Stereotactic Body Radiotherapy for Primary Lung Cancer at a Dose of 50 Gy Total in Five Fractions to the Periphery of the Planning Target Volume Calculated Using a Superposition Algorithm. / Takeda, Atsuya; Sanuki, Naoko; Kunieda, Etsuo; Ohashi, Toshio; Oku, Yohei; Takeda, Toshiaki; Shigematsu, Naoyuki; Kubo, Atsushi.

In: International Journal of Radiation Oncology Biology Physics, Vol. 73, No. 2, 01.02.2009, p. 442-448.

Research output: Contribution to journalArticle

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abstract = "Purpose: To retrospectively analyze the clinical outcomes of stereotactic body radiotherapy (SBRT) for patients with Stages 1A and 1B non-small-cell lung cancer. Methods and Materials: We reviewed the records of patients with non-small-cell lung cancer treated with curative intent between Dec 2001 and May 2007. All patients had histopathologically or cytologically confirmed disease, increased levels of tumor markers, and/or positive findings on fluorodeoxyglucose positron emission tomography. Staging studies identified their disease as Stage 1A or 1B. Performance status was 2 or less according to World Health Organization guidelines in all cases. The prescribed dose of 50 Gy total in five fractions, calculated by using a superposition algorithm, was defined for the periphery of the planning target volume. Results: One hundred twenty-one patients underwent SBRT during the study period, and 63 were eligible for this analysis. Thirty-eight patients had Stage 1A (T1N0M0) and 25 had Stage 1B (T2N0M0). Forty-nine patients were not appropriate candidates for surgery because of chronic pulmonary disease. Median follow-up of these 49 patients was 31 months (range, 10-72 months). The 3-year local control, disease-free, and overall survival rates in patients with Stages 1A and 1B were 93{\%} and 96{\%} (p = 0.86), 76{\%} and 77{\%} (p = 0.83), and 90{\%} and 63{\%} (p = 0.09), respectively. No acute toxicity was observed. Grade 2 or higher radiation pneumonitis was experienced by 3 patients, and 1 of them had fatal bacterial pneumonia. Conclusions: The SBRT at 50 Gy total in five fractions to the periphery of the planning target volume calculated by using a superposition algorithm is feasible. High local control rates were achieved for both T2 and T1 tumors.",
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AU - Sanuki, Naoko

AU - Kunieda, Etsuo

AU - Ohashi, Toshio

AU - Oku, Yohei

AU - Takeda, Toshiaki

AU - Shigematsu, Naoyuki

AU - Kubo, Atsushi

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