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Hypofractionated Stereotactic Radiotherapy (HypoFXSRT) For Stage I Non-small Cell Lung Cancer: Updated Results Of 257 Patients In A Japanese Multi-institutional Study
H. Onishi, H. Shirato, Y. Nagata, M. Hiraoka, Masaharu Fujino, K. Gomi, Y. Niibe, K. Karasawa, K. Hayakawa, Y. Takai, T. Kimura, A. Takeda, A. Ouchi, M. Hareyama, M. Kokubo, R. Hara, J. Itami, K. Yamada, T. Araki
Published 2007 · Medicine
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Introduction: Hypofractionated stereotactic radiotherapy (HypoFXSRT) has recently been used for the treatment of small lung tumors. We retrospectively analyzed the treatment outcome of HypoFXSRT for stage I non-small cell lung cancer (NSCLC) treated in a Japanese multi-institutional study. Methods: This is a retrospective study to review 257 patients with stage I NSCLC (median age, 74 years: 164 T1N0M0, 93 T2N0M0) were treated with HypoFXSRT alone at 14 institutions. Stereotactic three-dimensional treatment was performed using noncoplanar dynamic arcs or multiple static ports. A total dose of 18 to 75 Gy at the isocenter was administered in one to 22 fractions. The median calculated biological effective dose (BED) was 111 Gy (range, 57–180 Gy) based on α/β = 10. Results: During follow-up (median, 38 months), pulmonary complications of above grade 2 arose in 14 patients (5.4%). Local progression occurred in 36 patients (14.0%), and the local recurrence rate was 8.4% for a BED of 100 Gy or more compared with 42.9% for less than 100 Gy (p < 0.001). The 5-year overall survival rate of medically operable patients was 70.8% among those treated with a BED of 100 Gy or more compared with 30.2% among those treated with less than 100 Gy (p < 0.05). Conclusions: Although this is a retrospective study, HypoFXSRT with a BED of less than 180 Gy was almost safe for stage I NSCLC, and the local control and overall survival rates in 5 years with a BED of 100 Gy or more were superior to the reported results for conventional radiotherapy. For all treatment methods and schedules, the local control and survival rates were better with a BED of 100 Gy or more compared with less than 100 Gy. HypoFXSRT is feasible for curative treatment of patients with stage I NSCLC.
This paper references
Lung Cancer in Japan: Analysis of Lung Cancer Registry for Resected Cases in 1994.
T. Shirakusa (2002)
The role of radiotherapy in treatment of stage I non-small cell lung cancer.
X. Qiao (2003)
Adaptive radiotherapy in stereotactic radiotherapy of extracranial targets: Integration of CT-verification on the treatment couch using a dedicated software to calculate the current stereotactic coordinate including evaluation of breathing mobility
J. Wulf (2004)
Prognostic factors in the treatment of node-negative nonsmall cell lung carcinoma with radiotherapy alone.
P. Kupelian (1996)
Computed tomography-guided frameless stereotactic radiotherapy for stage I non-small cell lung cancer: a 5-year experience.
M. Uematsu (2001)
New guidelines to evaluate the response to treatment in solid tumors
P. Therasse (2000)
Stereotactic hypofractionated high‐dose irradiation for stage I nonsmall cell lung carcinoma
H. Onishi (2004)
Hyperfractionated radiotherapy alone for clinical stage I nonsmall cell lung cancer.
B. Jeremic (1997)
Extracranial stereotactic radioablation: results of a phase I study in medically inoperable stage I non-small cell lung cancer.
R. Timmerman (2003)
American College of Chest Physicians: treatment of stage I non-small cell lung carcinoma
WR Smythe (2003)
Limited field irradiation for medically inoperable patients with peripheral stage I non-small cell lung cancer.
K. Hayakawa (1999)
Treatment of stage I non-small cell lung carcinoma.
W. Smythe (2003)
A new approach to dose escalation in non-small-cell lung cancer.
M. Mehta (2001)
Radiotherapy for patients with medically inoperable stage I nonsmall cell lung carcinoma
G. Sibley (1998)
Current operative morbidity associated with elective surgical resection for lung cancer.
J. Deslauriers (1989)
Focal, high dose, and fractionated modified stereotactic radiation therapy for lung carcinoma patients
M. Uematsu (1998)
Computed tomography-guided frameless stereotactic radiography for stage I non-small-cell lung cancer: 5-year experience
M Uematsu (2001)
Stereotactic body radiation therapy of early-stage non-small-cell lung carcinoma: phase I study.
R. Mcgarry (2005)
Small‐volume image‐guided radiotherapy using hypofractionated, coplanar, and noncoplanar multiple fields for patients with inoperable Stage I nonsmall cell lung carcinomas
S. Fukumoto (2002)
External stereotactic radioablation: results of a phase I study in medically inoperable stage I non-small cell lung cancer patients
R Timmerman (1955)
Radiation therapy alone for stage I non-small cell lung cancer.
L. Kaskowitz (1993)
Clinical outcomes of a phase I/II study of 48 Gy of stereotactic body radiotherapy in 4 fractions for primary lung cancer using a stereotactic body frame.
Y. Nagata (2005)
The international system for staging lung cancer.
C. Mountain (2000)
Clinical outcomes of stereotactic radiotherapy for stage I non-small cell lung cancer using a novel irradiation technique: patient self-controlled breath-hold and beam switching using a combination of linear accelerator and CT scanner.
H. Onishi (2004)
Involved-field radiotherapy alone for early-stage non-small-cell lung cancer.
P. Cheung (2000)
On using the linear-quadratic model in daily clinical practice.
R. Yaes (1991)
Prognosis and survival after resection for bronchogenic carcinoma based on the 1997 TNM-staging classification: the Japanese experience.
T. Naruke (2001)
Stereotactic single-dose radiotherapy of stage I non-small-cell lung cancer (NSCLC).
H. Hof (2003)
Stereotactic radiotherapy for primary lung cancer and pulmonary metastases: a noninvasive treatment approach in medically inoperable patients.
J. Wulf (2004)
Lung cancer in Japan: Analysis of lung cancer registry for resected cases in 1999
K. Shimokata (2007)
This paper is referenced by
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D. Kannarunimit (2015)
Prognostic Probability of FDG-PET before Stereotactic Ablative Radiotherapy for Primary Lung Cancer-Review of the Literature
K. Jingu (2014)
Chapter 2 Radiation oncology: overview and recent advances
Max R. Dahele (2010)
Phase I study of stereotactic body radiation therapy for centrally located stage IA non-small cell lung cancer (JROSG10-1)
T. Kimura (2017)
Stereotactic body radiation therapy for lung, spine and oligometastatic disease: current evidence and future directions.
E. Dunne (2018)
Stereotactic radiation therapy for inoperable, early-stage non-small-cell lung cancer
M. Dahele (2009)
Stage I nonsmall cell lung cancer in patients aged ≥75 years
Cornelis J. A. Haasbeek (2010)
Analysis of first recurrence and survival in patients with stage I non-small cell lung cancer treated with surgical resection or stereotactic radiation therapy.
T. Crabtree (2014)
Fractionated stereotactic body radiation therapy for medically inoperable stage I lung cancer adjacent to central large bronchus.
S. Y. Song (2009)
High‐dose proton therapy and carbon‐ion therapy for stage I nonsmall cell lung cancer
H. Iwata (2010)
Rapid disease progression with delay in treatment of non-small-cell lung cancer.
N. Mohammed (2011)
Radiation dose-volume effects in the esophagus.
M. Werner-wasik (2010)
Stereotactic body radiation therapy versus surgical resection for stage I non-small cell lung cancer.
T. Crabtree (2010)
Stereotactic radiotherapy for stage I lung cancer: current results and new developments.
S. Senan (2010)
State-of-the-art lung cancer radiation therapy
J. Belderbos (2009)
Stereotactic body radiotherapy versus surgery for medically operable Stage I non-small-cell lung cancer: a Markov model-based decision analysis.
A. Louie (2011)
75 – Stereotactic Body Radiation Therapy
I. Gibbs (2010)
Carbon ion radiotherapy for elderly patients 80 years and older with stage I non-small cell lung cancer.
T. Sugane (2009)
Proton-Based Stereotactic Ablative Radiotherapy in Early-Stage Non-Small-Cell Lung Cancer
J. Grant (2014)
Modern Radiotherapy Techniques in Lung Cancer
Yasemin Bolukbasi (2016)
Local Control Rates of Metastatic Renal Cell Carcinoma (RCC) to Thoracic, Abdominal, and Soft Tissue Lesions Using Stereotactic Body Radiotherapy (SBRT)
B. Altoos (2015)
Medically inoperable peripheral lung cancer treated with stereotactic body radiation therapy
K. Kelley (2015)
Prognostic Factors for Overall and Disease-specific Survival of Stage I Non-Small-Cell Lung Cancer after Stereotactic Body Radiotherapy: A Retrospective Analysis
T. Abe (2017)
Percutaneous radiofrequency ablation of clinical stage I non-small cell lung cancer.
T. Hiraki (2011)
Stereotactic ablative body radiotherapy versus conventionally fractionated radiotherapy for early stage large cell neuroendocrine carcinoma of the lung
R. Wegner (2020)
Local control rates of metastatic renal cell carcinoma (RCC) to the bone using stereotactic body radiation therapy: Is RCC truly radioresistant?
A. Amini (2015)
Proton therapy for lung cancer : Current uses and future applications for early stage and locally advanced non-small cell lung cancer
J. Cohen ()
Role of On-Table Plan Adaptation in MR-Guided Ablative Radiation Therapy for Central Lung Tumors.
T. Finazzi (2019)
Pretreatment 18F-fluorodeoxyglucose Uptake in the Lung Parenchyma Predicts Poor Survival After Stereotactic Body Radiation Therapy in Patients With Stage I Non-Small Cell Lung Cancer
Y. Satoh (2018)
Is radiofrequency ablation or stereotactic ablative radiotherapy the best treatment for radically treatable primary lung cancer unfit for surgery?
S. Renaud (2013)
Stereotactic body radiation therapy: transcending the conventional to improve outcomes.
T. Dilling (2008)
Stereotactic body radiation therapy versus multi-fraction radiation therapy for bone metastases.
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