OA11.04 Impact of Local Control on Cause-Specific Survival After SBRT for Early-Stage NSCLC: Dynamic Prediction With Landmarking

PURPOSE: There are no definitive randomized studies that compare radiotherapy (RT) with surgery for tonsillar cancer. The purpose of this study was to evaluate the results of RT alone and RT combined with a planned neck dissection for carcinoma of the tonsillar area and to compare these data with the results of treatment with primary surgery.PATIENTS AND METHODS: Four hundred patients were treated between October 1964 and December 1997 and observed for at least 2 years. One hundred forty-one patients underwent planned neck dissection, and 18 patients received induction (17 patients) or concomitant (one patient) chemotherapy.RESULTS: Five-year local control rates, by tumor stage, were as follows: T1, 83%; T2, 81%; T3, 74%; and T4, 60%. Multivariate analysis revealed that local control was significantly influenced by tumor stage (P = .0001), fractionation schedule (P = .0038), and external beam dose (P = .0227). Local control after RT for early-stage cancers was higher for tonsillar fossa/posterior pillar cancers than for those arising from the anterior tonsillar pillar. Five-year cause-specific survival rates, by disease stage, were as follows: I, 100%; II, 86%; III, 82%; IVa, 63%; and IVb, 22%. Multivariate analysis revealed that cause-specific survival was significantly influenced by overall stage (P = .0001), planned neck dissection (P = .0074), and histologic differentiation (P = .0307). The incidence of severe late complications after treatment was 5%.CONCLUSION: RT alone or combined with a planned neck dissection provides cure rates that are as good as those after surgery and is associated with a lower rate of severe complications.

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Prolonged Overall Treatment Time Negatively Affects the Outcomes of Stereotactic Body Radiotherapy for Early-Stage Non-Small Cell Lung Cancer: A Propensity Score-Weighted, Single-Center Analysis

10.21203/rs.3.rs-100183/v1 ◽

2020 ◽

Author(s):

TOSHIKI IKAWA ◽

Takahiro Tabuchi ◽

Koji Konishi ◽

Masahiro Morimoto ◽

Takero Hirata ◽

...

Keyword(s):

Overall Survival ◽

Propensity Score ◽

Local Control ◽

Treatment Time ◽

Early Stage ◽

Small Cell ◽

Tumor Control ◽

Small Cell Lung ◽

Overall Treatment Time ◽

Early Stage Nsclc

Abstract BackgroundPrevious studies have reported conflicting results for the effect of overall treatment time (OTT) on tumor control with stereotactic body radiotherapy (SBRT) for early-stage non-small cell lung cancer (NSCLC). To examine this effect, we conducted a propensity score-weighted, retrospective, observational study at a single institution.MethodsWe analyzed the data of 200 patients with early-stage NSCLC who underwent SBRT (48 Gy in 4 fractions) at our institution between January 2007 and October 2013. Patients were grouped into consecutive (OTT = 4–5 days, n = 116) or non-consecutive treatment groups (OTT = 6–10 days, n = 84). The outcomes of interest were local control and overall survival. The Cox regression model was used with propensity score and inverse probability of treatment weighting.ResultsThe median OTTs in the consecutive and non-consecutive groups were 4 and 6 days, respectively. The 5-year local control and overall survival rates in the consecutive group vs. non-consecutive group were 86.3% vs. 77.2% and 55.5% vs. 51.8%, respectively. After propensity score-weighting, consecutive SBRT was associated with positive local control (adjusted hazard ratio 0.30, 95% confidence interval 0.14–0.65; p=0.002) and overall survival benefits (adjusted hazard ratio 0.56, 95% confidence interval 0.34–0.91; p=0.019). ConclusionsProlonged OTT negatively affected the outcomes of patients with early-stage NSCLC treated with SBRT. To our knowledge, this is the first study to show that in patients with early-stage NSCLC treated with the same dose-fractionation regimen, consecutive SBRT has a more beneficial effect on tumor control than does non-consecutive SBRT.

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Should stereotactic body radiotherapy doses be adjusted according to tumor size in early-stage non-small-cell lung cancer? A systematic review and meta-analysis

Future Oncology ◽

10.2217/fon-2019-0240 ◽

2019 ◽

Vol 15 (26) ◽

pp. 3071-3079 ◽

Cited By ~ 1

Author(s):

Hui Luo ◽

Yingying Cui ◽

Hengli Song ◽

Ronghu Mao ◽

Qiang Gao ◽

...

Keyword(s):

Lung Cancer ◽

Local Control ◽

Tumor Size ◽

Early Stage ◽

Local Control Rate ◽

Small Cell ◽

Small Cell Lung ◽

Stage Ib ◽

Early Stage Nsclc ◽

Stage Ia

Aim: Treatment schedules of stereotactic body radiotherapy (SBRT) for patients with early-stage non-small-cell lung cancer (NSCLC) are varied. The aim of this study was to clarify the optimal biologically effective dose (BED) for the treatment of stage I NSCLC. Methods: Research findings published after 1990 detailing the effects of SBRT on early-stage NSCLC patients were compiled from the Medline, Embase, Web of Science and Cochrane Library. For comparative analyses, two groups were divided into moderate BED (100–150 Gy) and high BED (BED ≥150 Gy). Results: Two moderate BED studies and four high BED studies were selected for analysis. The results from the analysis of four moderate and high groups suggest that the 2-year local control rate was significantly lower in moderate BED group than that of high BED group (p = 0.04). Subgroup analysis by tumor size was also conducted. For patients with Stage IA disease, no difference in overall survival (OS) was found. No statistically significant difference was achieved in the instance of Stage IB tumor; however, the 2-year OS showed a trend in favor of high BED (p = 0.08). The remaining two studies, comparing 106 Gy (Stage IA) to 120-132 Gy (Stage IB) treatment, indicated a significantly higher 3-year OS in the 106 Gy group than that of 120–132 Gy group (p = 0.009). Conclusion: In patients with early-stage NSCLC treated with SBRT, our analyses suggested that a moderate BED, especially 106 Gy, is sufficient for the treatment of Stage IA tumor; although a high BED conferred no significant benefit to OS for the treatment of Stage IB tumor, a higher local control rate was achieved. Further detailed studies should be performed to explore the optimal BED for the treatment of Stage IB tumor.

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MA03.08 Quantifying Survival in Early-Stage NSCLC: Implications of Relative Survival vs Cause-Specific Survival

Journal of Thoracic Oncology ◽

10.1016/j.jtho.2016.11.394 ◽

2017 ◽

Vol 12 (1) ◽

pp. S355-S356

Author(s):

Kay See Tan ◽

Takashi Eguchi ◽

Prasad Adusumilli

Keyword(s):

Early Stage ◽

Relative Survival ◽

Early Stage Nsclc ◽

Cause Specific Survival

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Long term results of single high dose Stereotactic Body Radiotherapy in the treatment of primary lung tumors

Scientific Reports ◽

10.1038/s41598-019-51900-8 ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 1

Author(s):

Luca Nicosia ◽

Chiara Reverberi ◽

Linda Agolli ◽

Luca Marinelli ◽

Vitaliana De Sanctis ◽

...

Keyword(s):

Single Dose ◽

Local Control ◽

Stereotactic Body Radiotherapy ◽

Early Stage ◽

Univariate Analysis ◽

Long Term Results ◽

High Dose ◽

Early Stage Nsclc

Abstract Stereotactic body radiotherapy (SBRT) is a standard treatment for inoperable early-stage NSCLC, with local control rates comparable to surgical series. Promising results have been achieved utilizing a high single-dose schedule. The aim of our study was to evaluate long-term local control and toxicity in a series of patients treated with SBRT delivered in a single dose of 30 Gy. 44 patients affected by early stage NSCLC were treated with SBRT delivered in a single dose of 30 Gy. Survival and prognostic factors were retrospectively evaluated. Median follow-up was 34 months (range 3–81). Three- and 5-year local progression-free survival (LPFS) were 87.8% and 87.8% respectively (median 30 months; range 6–81 months), 3- and 5-year OS and CSS were 64.9% and 36.9%, 80.9% and 65.5%, respectively. Two (4.6%) cases of grade 3 pneumonitis occurred. At the univariate analysis lesion diameter ≤ 25 mm was predictive of better 5-year LPFS (95.8% versus 56.3%; p = 0.003) and 5-year PFS (69.8% versus 27.8%; p = 0.002). The results of our study indicated a high local control, survival and tolerability after a long-term follow-up with the use of SBRT 30 Gy single dose. Further prospective studies could better define the role of this regimen.

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Clinical Outcome of CT-Guided Stereotactic Ablative Brachytherapy for Unresectable Early Non-Small Cell Lung Cancer: A Retrospective, Multicenter Study

Frontiers in Oncology ◽

10.3389/fonc.2021.706242 ◽

2021 ◽

Vol 11 ◽

Author(s):

Zhe Ji ◽

Bin Huo ◽

Shifeng Liu ◽

Qinghua Liang ◽

Chao Xing ◽

...

Keyword(s):

Lung Cancer ◽

Multivariate Analysis ◽

Prognostic Factors ◽

Chest Wall ◽

Local Control ◽

Early Stage ◽

Small Cell ◽

Small Cell Lung ◽

Ct Guided ◽

Early Stage Nsclc

ObjectiveTo analyze the efficacy and safety of low dose rate stereotactic ablative brachytherapy (L-SABT) for treatment of unresectable early-stage non-small cell lung cancer (NSCLC).MethodsData of patients with early-stage NSCLC who received CT-guided L-SABT (radioactive I-125 seeds implantation) at eight different centers from December 2010 to August 2020 were retrospectively analyzed. Treatment efficacy and complications were evaluated.ResultsA total of 99 patients were included in this study. Median follow-up duration was 46.3 months (6.1-119.3 months). The 1-year, 3-year, and 5-year local control rates were 89.1%, 77.5%, and 75.7%, respectively. The 1-year, 3-year, and 5-year overall survival rates were 96.7%, 70.1%, and 54.4%, respectively. Treatment failure occurred in 38.4% of patients. Local/regional recurrence, distant metastasis, and recurrence combined with metastasis accounted for 15.1%, 12.1%, and 11.1%, respectively. Pneumothorax occurred in 47 patients (47.5%) with 19 cases (19.2%) needing closed drainage. The only radiation-related adverse reaction was two cases of grade 2 radiation pneumonia. KPS 80–100, T1, the lesion was located in the left lobe, GTV D90 ≥150 Gy and the distance between the lesion and chest wall was < 1 cm, were associated with better local control (all P < 0.05); on multivariate analysis KPS, GTV D90, and the distance between the lesion and chest wall were independent prognostic factors for local control (all P < 0.05). KPS 80–100, T1, GTV D90 ≥150 Gy, and the distance between the lesion and chest wall was < 1 cm were also associated with better survival (all P < 0.05); on multivariate analysis KPS, T stage, and GTV D90 were independent prognostic factors for survival (all P < 0.05). The incidence of pneumothorax in patients with lesions <1 cm and ≥1cm from the chest wall was 33.3% and 56.7%, respectively, and the differences were statistically significant (P = 0.026).ConclusionL-SABT showed acceptable efficacy in the treatment of unresectable early-stage NSCLC. But the incidence of pneumothorax is high. For patients with T1 stage and lesions <1 cm from the chest wall, it may have better efficacy. Prescription dose greater than 150 Gy may bring better results.

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