Author of

• 10692

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  P1.08 - Poster Session 1 - Radiotherapy (ID 195)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Radiation Oncology + Radiotherapy
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/28/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 10699

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    P1.08-007 - Outcomes and prognostic factors of stage I non-small cell lung cancer patients treated with stereotactic body radiotherapy or 3-dimentional conformal radiotherapy. (ID 780)

    09:30 - 09:30  |  Author(s): K. Takenaka
    • Abstract

    Background
    Although stereotactic body radiotherapy (SBRT) has become a one of the preferred treatment options for patients with stage I non-small cell lung cancer, the patients are not always suitable for SBRT. The purpose of this study was to present the treatment outcomes and prognostic factors for stage I NSCLC treated with SBRT or 3-dimentional conformal radiotherapy (3DCRT).

    Methods
    The medical records of 77 patients with stage I NSCLC treated in our hospital were retrospectively reviewed. Forty-four patients were treated with SBRT which was delivered a total dose of 48Gy in 4 fractions　for one week. Thirty-three patients were treated with 3DCRT which was delivered a total dose of 60-66Gy in 20-30 fractions. SBRT was done with the real-time tumor-tracking system (RTRT) using 3 to 4 fiducial gold markers. 3DCRT was adapted to the patients who had difficulty of bronchoscopic implantation of fiducial markers, centrally located tumors or low performance status. In dose calculation for the majority of patients, inhomogeneity was corrected by the superposition method. Univariate and multivariate analysis were performed for predictive factors. .

    Results
    Median follow-up time was 30 months (range, 1 to 94 months). The 3-year local control (LC), disease-free survival (DFS), and overall survival rate (OS) of all patients were 69.2%, 57.1%, and 68.6%, respectively. There was no significant difference between the two groups in 3-year LC (SBRT, 78.6%; 3DCRT, 58.5%; p=0.146) and 3-year OS (SBRT, 66.4%; 3DCRT, 71.1%; p=0.83), but in 3-year DFS SBRT was superior to 3DCRT (SBRT, 66.2%; 3DCRT, 46.3%; p=0.039). Multivariate analysis detected pathological type and patient’s age as significant predictive factors for LC and DFS, respectively. Especially the histologic type of squamous cell carcinoma was detected as an adverse predictive factor for local control. The type of radiotherapy was not detected as a prognostic factor on multivariate analysis. No serious radiation morbidity was observed with either RT method.

    Conclusion
    Our results suggested that 3DCRT may be a good alternative treatment for patients who are not suitable for SBRT. Well-designed prospective studies investigating the optimal schedule of dose fractionation in early-stage lung cancer are warranted.