open access

Vol 79, No 5 (2011)
ORIGINAL PAPERS
Published online: 2011-08-22
Submitted: 2013-02-22
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The outcomes of three-dimensional conformal radiotherapy for early-stage non-small-cell lung cancer patients eligible and ineligible for stereotactic body radiotherapy

Milena Kołodziejczyk, Lucyna Kępka, Dobromira Tyc-Szczepaniak, Marek Wierzchowski
Pneumonol Alergol Pol 2011;79(5):326-336.

open access

Vol 79, No 5 (2011)
ORIGINAL PAPERS
Published online: 2011-08-22
Submitted: 2013-02-22

Abstract

Introduction: Stereotactic body radiotherapy (SBRT) in early-stage non-small-cell lung cancer (NSCLC) results in promising outcomes, comparable with the outcomes of surgery. However, not all such patients are good candidates for this treatment. We conducted a retrospective evaluation of the outcomes of three-dimensional conformal radiotherapy (3D-CRT) in patients with stage I/II NSCLC with a special focus on the outcomes of patients who were eligible for SBRT but received 3D-CRT due to the unavailability of the former.
Material and methods: We evaluated 132 consecutive patients with stage I/II NSCLC who had received radical 3D-CRT between 1998 and 2009. As various radiotherapy schedules had been used, biologically equivalent doses (BEDs) were calculated for all the patients. A total of 68 patients were eligible for SBRT (peripheral T1-3 N0 tumours < 5 cm in diameter). Overall survival (OS) and local progression free survival (LPFS) were estimated using Kaplan-Meier methodology for the entire study population and for the groups eligible and ineligible for SBRT. Univariate and multivariate analyses were performed for the prognostic factors.
Results: Median BED in the study population was 74 Gy (58–82 Gy). Patients eligible for SBRT had a significantly lower gross tumour volume (GTV) than the other patients (p < 0.00001). Three-year OS and LPFS were 37% and 50%, respectively. When we compared patients eligible for SBRT and those ineligible for SBRT the only significant difference was for three-year LPFS (58% v. 35%, p = 0.04). Multivariate analysis showed that only GTV, performance status and tumour stage were significantly correlated with local curability.
Conclusions: We showed an improved local control following 3D-CRT in patients eligible for SBRT compared to the other patients. However, also in these cases, local control was inferior compared to the outcomes of SBRT reported in the literature.
Pneumonol. Alergol. Pol. 2011; 79, 5: 326–336

Abstract

Introduction: Stereotactic body radiotherapy (SBRT) in early-stage non-small-cell lung cancer (NSCLC) results in promising outcomes, comparable with the outcomes of surgery. However, not all such patients are good candidates for this treatment. We conducted a retrospective evaluation of the outcomes of three-dimensional conformal radiotherapy (3D-CRT) in patients with stage I/II NSCLC with a special focus on the outcomes of patients who were eligible for SBRT but received 3D-CRT due to the unavailability of the former.
Material and methods: We evaluated 132 consecutive patients with stage I/II NSCLC who had received radical 3D-CRT between 1998 and 2009. As various radiotherapy schedules had been used, biologically equivalent doses (BEDs) were calculated for all the patients. A total of 68 patients were eligible for SBRT (peripheral T1-3 N0 tumours < 5 cm in diameter). Overall survival (OS) and local progression free survival (LPFS) were estimated using Kaplan-Meier methodology for the entire study population and for the groups eligible and ineligible for SBRT. Univariate and multivariate analyses were performed for the prognostic factors.
Results: Median BED in the study population was 74 Gy (58–82 Gy). Patients eligible for SBRT had a significantly lower gross tumour volume (GTV) than the other patients (p < 0.00001). Three-year OS and LPFS were 37% and 50%, respectively. When we compared patients eligible for SBRT and those ineligible for SBRT the only significant difference was for three-year LPFS (58% v. 35%, p = 0.04). Multivariate analysis showed that only GTV, performance status and tumour stage were significantly correlated with local curability.
Conclusions: We showed an improved local control following 3D-CRT in patients eligible for SBRT compared to the other patients. However, also in these cases, local control was inferior compared to the outcomes of SBRT reported in the literature.
Pneumonol. Alergol. Pol. 2011; 79, 5: 326–336
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Keywords

non-small-cell lung cancer; radiotherapy; conformal radiotherapy; SBRT; early-stage disease

About this article
Title

The outcomes of three-dimensional conformal radiotherapy for early-stage non-small-cell lung cancer patients eligible and ineligible for stereotactic body radiotherapy

Journal

Advances in Respiratory Medicine

Issue

Vol 79, No 5 (2011)

Pages

326-336

Published online

2011-08-22

Bibliographic record

Pneumonol Alergol Pol 2011;79(5):326-336.

Keywords

non-small-cell lung cancer
radiotherapy
conformal radiotherapy
SBRT
early-stage disease

Authors

Milena Kołodziejczyk
Lucyna Kępka
Dobromira Tyc-Szczepaniak
Marek Wierzchowski

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