Purpose:
To review treatment outcomes for stereotactic body radiotherapy (sbrt) in medically operable patients with stage i non-small-cell lung cancer (nsclc), using a japanese multi-institutional database.
Patients and methods:
Between 1995 and 2004, a total of 87 patients with stage i nsclc (median age, 74 years; t1n0m0, n=65; t2n0m0, n=22) who were medically operable but refused surgery were treated using sbrt alone in 14 institutions. stereotactic three-dimensional treatment was performed using noncoplanar dynamic arcs or multiple static ports. total dose was 45-72.5 gy at the isocenter, administered in 3-10 fractions. median calculated biological effective dose was 116 gy (range, 100-141 gy). data were collected and analyzed retrospectively.
Results:
During follow-up (median, 55 months), cumulative local control rates for t1 and t2 tumors at 5 years after sbrt were 92% and 73%, respectively. pulmonary complications above grade 2 arose in 1 patient (1.1%). five-year overall survival rates for stage ia and ib subgroups were 72% and 62%, respectively. one patient who developed local recurrences safely underwent salvage surgery.
Conclusion:
Stereotactic body radiotherapy is safe and promising as a radical treatment for operable stage i nsclc. the survival rate for sbrt is potentially comparable to that for surgery.