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A. Binarova



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

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Radiation Oncology + Radiotherapy
    • Presentations: 1
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      P1.08-013 - Stereotactic Ablative Radiotherapy of Early Stage Non-Small Cell Lung Cancer (ID 1607)

      09:30 - 09:30  |  Author(s): A. Binarova

      • Abstract

      Background
      To evaluate the feasibility of stereotactic ablative radiotherapy (SABR) for Non-Small Cell Lung Cancer (NSCLC), especially when tumor tracking system is used.

      Methods
      From August 2010 to March 2013, 66 patients (44 male, 22 female, mean age 70, range 55-86 years) with node-negative NSCLC were treated. CyberKnife ver. 8.5 and Multiplan ver. 3.2 were used. Mostly, 60 Gy in 3-5 fraction was applied for GTV (CT lung window –W2000 L700) + 3 mm margin, in case of tumor dimension smaller than 1 cm, 30-33 Gy in one fraction was delivered. XSight Lung (XLT) for real-time tumor tracking or Xsight Spine (XST) for internal target volume (ITV) were used. Volume of GTV, treatment time, toxicity, 1-year year local control (LC), free survival (PFS) and 2-year overal survival (OS) were analyzed.

      Results
      Of the 66 patients, XLT and XST were used in 83% and 17%, respectively. Median tumor volume was 18 ml (range 2-137 ml). Mean treatment time of one fraction was 56 minutes (range 20-90 minutes). Acute toxicity was mild with no need for therapeutic intervention. We have noticed only radiological signs of late pneumonitis and/or fibrosis with no clinical manifestation. One year LC, PFS and OS were 95%, 85% and 92%, respectively. Two years OS was 75%. Figure 1 Fig. 1. Overall survival Figure 2 Fig. 2. Dose distribution, tumoricidal 60Gy isodose (orange), significant lung tissue sparing - 7Gy isodose (dark blue)

      Conclusion
      CyberKnife´s SABR of NSCLC is feasible and our image-guidance protocol allows to use high number of online tumor tracking to spare as much lung tissue as possible. This results in excellent overall survival and minimal toxicity in patients that were not candidates for surgery. Longer follow-up is necessary for mature data.