Southern Clinics of Istanbul Eurasia (Jun 2017)

Results of Treatment with Stereotactic Radiotherapy in Patients with Early-Stage Medically Inoperable Non-Small Cell Lung Cancer

  • Cengiz Gemici

DOI
https://doi.org/10.14744/scie.2016.64624
Journal volume & issue
Vol. 28, no. 1
pp. 39 – 42

Abstract

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INTRODUCTION[|]This study aimed to determine local control and overall survival of patients with medically inoperable early-stage non-small cell lung cancer treated with stereotactic ablative radiotherapy.[¤]METHODS[|]A total of 35 patients [6 (17%) females and 29 (83%) males] with medically inoperable early-stage non-small cell lung cancer and who were treated with stereotactic ablative body radiotherapy by a CyberKnife robotic radiotherapy machine between 2009 and 2015 were evaluated retrospectively.[¤]RESULTS[|]The median age of patients was 69 (55–83) years. The ECOG performance score of 24 (67%) and 11 (33%) patients were 1 and 2, respectively. Tumor was staged as cT1 in 19 (54%) patients and cT2 in 16 (46%) patients. Tumor was centrally located in 6 (17%) patients and peripheral in 29 (83%) patients. The mean planning target volume (PTV) was 124.1 mm³ (14.5–233.7 mm³). As regards the tumor-tracking system, X-Sight lung tracking system was used in 31 (88%) patients, gold fiducials in 3 (9%) patients, and X-Sight spine tracking system in 1 (3%) patient. 43 Gy (30-60 Gy) radiotherapy has been described to 81% isodose line (70-92%) and delivered in 3 and 5 fractions to 33 (94%), and 2 (6%) patients respectively.[¤]DISCUSSION AND CONCLUSION[|]During 21 months median follow-up time (2–51 months) local recurrence was observed in only 2 (5%) patients. The 2-year local control rate was 93.4%, the 2-year overall survival rate was 45%, and the mean survival time was 21.4 months. Grade 3 toxicity was observed in only two patients; no grade 4–5 toxicity was observed. The effect of age, performance status, T stage, PTV volume, and radiation dose over local control and overall survival were investigated, but no significant correlation was found. A high local control rate with no major toxicity was obtained by stereotactic ablative body radiotherapy in the patients with medically inoperable early-stage non-small cell lung cancer.[¤]

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