Stereotactic Body Radiation Therapy Safe and Effective for Patients with Stage I Non–Small Cell Lung Cancer
According to a recently published analysis in the Journal of Thoracic Oncology, stereotactic body radiotherapy (SBRT) is safe and effective for patients with stage I non–small cell lung cancer (NSCLC) in a multicenter environment. In addition, radiotherapy dosage was identified as a major treatment factor influencing local tumor control and overall survival.
SBRT is considered the treatment of choice for patients with early-stage NSCLC who are not candidates for surgery because of existing medical conditions. Several prospective phase II trials reported high rates of local tumor control in this population, but these studies included only a small number of patients, had varied methodology, and were mainly conducted in specialized centers. Therefore, the safety and efficacy of SBRT in routine clinical practice outside of study protocols is unclear.
Retrospective Analysis
The Extracranial Stereotactic Radiotherapy working group of German Society for Radiation Oncology performed a patterns-of-care and patterns-of-outcome analysis looking at safety and efficacy of SBRT for stage I NSCLC in Germany and Austria.
The researchers analyzed data from 582 patients treated at 13 institutions (all but one were academic hospitals) between 1998 and 2011. Average follow-up for all patients was 21.4 months, with the maximum being 144 months, or 12 years); follow-up was more than 3 years for 108 patients. Three-year freedom from local progression was 79.6% for all 582 patients, and overall survival was 47.1%.
The biologic effective dosage was the most significant factor influencing freedom from local progression and overall survival. No evidence of a learning curve or improvement of results with larger SBRT experience and implementation of new radiotherapy technologies was observed.
The group concluded that SBRT for stage I NSCLC was safe and effective in this multicenter, academic environment, despite considerable interinstitutional variability and time trends in SBRT practice.
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