Real-World Results of Stereotactic Body Radiotherapy for 399 Medically Operable Patients with Stage I Histology-Proven Non-Small Cell Lung Cancer

被引：2

作者：

Onishi, Hiroshi ^{[1
]}

Shioyama, Yoshiyuki ^{[2
]}

Matsumoto, Yasuo ^{[3
]}

Matsuo, Yukinori ^{[4
]}

Miyakawa, Akifumi ^{[5
]}

Yamashita, Hideomi ^{[6
]}

Matsushita, Haruo ^{[7
]}

Aoki, Masahiko ^{[8
]}

Nihei, Keiji ^{[9
]}

Kimura, Tomoki ^{[10
]}

Ishiyama, Hiromichi ^{[11
]}

Murakami, Naoya ^{[12
]}

Nakata, Kensei ^{[13
]}

Takeda, Atsuya ^{[14
]}

Uno, Takashi ^{[15
]}

Nomiya, Takuma ^{[16
]}

Taguchi, Hiroshi ^{[17
]}

Seo, Yuji ^{[18
]}

Komiyama, Takafumi ^{[1
]}

Marino, Kan ^{[1
]}

Aoki, Shinichi ^{[1
]}

Matsuda, Masaki ^{[1
]}

Akita, Tomoko ^{[1
]}

Saito, Masahide ^{[1
]}

机构：

[1] Univ Yamanashi, Fac Med, Dept Radiol, 1110 Shimokato, Chuo, Yamanashi 4093898, Japan

[2] SAGA HIMAT Fdn, Ion Beam Therapy Ctr, 3049 Harakoga Machi, Tosu 8410071, Japan

[3] Niigata Canc Ctr Hosp, Dept Radiat Oncol, 2-15-3 Kawagishi,Chuo Ku, Niigata 9518566, Japan

[4] Kyoto Univ, Grad Sch Med, Dept Radiat Oncol & Image Appl Therapy, 54 Kawaharacho,Sakyo Ku, Kyoto 6068507, Japan

[5] Nagoya City Univ, Sch Med, Dept Radiol, 1 Kawasumi,Mizuho Cho,Mizuho Ku, Nagoya 4678601, Japan

[6] Univ Tokyo, Dept Radiol, 7-3-1 Hongo,Bunkyo Ku, Tokyo 1138655, Japan

[7] Tohoku Univ, Sch Med, Dept Radiat Oncol, 2-1 Seiryo Machi,Aoba Ku, Sendai, Miyagi 9808574, Japan

[8] Hirosaki Univ, Grad Sch Med, Dept Radiat & Oncol, 5 Zaifu Cho, Hirosaki, Aomori 0368562, Japan

[9] Komagome Hosp, Infect Dis Ctr, Tokyo Metropolitan Canc, Dept Radiat Oncol, 3-18-22 Honkomagome,Bunkyo Ku, Tokyo 1138677, Japan

[10] Hiroshima Univ Hosp, Dept Radiat Oncol, 1-2-3 Kasumi Minami Ku, Hiroshima 7348551, Japan

[11] Kitasato Univ, Sch Med, Dept Radiat Oncol, 1-15-1 Kitasato,Minami Ku, Sagamihara, Kanagawa 2520375, Japan

[12] Natl Canc Ctr, Dept Radiat Oncol, 5-1-1 Tsukiji,Chuo Ku, Tokyo 1040045, Japan

[13] Sapporo Med Univ, Dept Radiat Oncol, S1W17,Chuo Ku, Sapporo, Hokkaido 0608556, Japan

[14] Ofuna Chuo Hosp, Radiat Oncol Ctr, 6-2-24 Ofuna, Kamakura, Kanagawa 2470056, Japan

[15] Chiba Univ, Grad Sch Med, Diagnost Radiol & Radiat Oncol, 1-8-1 Inohana,Chuo Ku, Chiba 2608670, Japan

[16] Yamagata Univ, Fac Med, Dept Radiat Oncol, 2-2-2 Iida Nishi, Yamagata, Yamagata 9909585, Japan

[17] Hokkaido Univ Hosp, Dept Radiat Oncol, North 14 West-5,Kita Ku, Sapporo 0608648, Japan

[18] Osaka Univ, Grad Sch Med, Dept Radiat Oncol, 2-2 D10 Yamada Oka, Suita, Osaka 5650871, Japan

来源：

CANCERS | 2023年 / 15卷 / 17期

关键词：

stereotactic body radiotherapy; stage I non-small cell lung cancer; operable; real-world evidence; LONG-TERM SURVIVAL; ABLATIVE RADIOTHERAPY; RADIATION-THERAPY; PULMONARY RESECTION; SUBLOBAR RESECTION; LIMITED RESECTION; PROSPECTIVE TRIAL; OUTCOMES; LOBECTOMY; SURGERY;

D O I：

10.3390/cancers15174382

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Simple Summary According to current guidelines, surgery is the standard treatment for stage I non-small cell lung cancer (NSCLC), despite no clear randomized trial demonstrating that surgery is superior to stereotactic body radiotherapy (SBRT). Therefore, this study aimed to provide real-world evidence of the usefulness of SBRT for medically operable patients with pathologically proven stage I NSCLC using a large Japanese multi-institutional database. A total of 399 patients from 20 institutions were included in the database. In the results, local progression-free survival was 84.2%, and the 3-year overall survival was 77.0%. The local progression-free survival rate was better in cases with tumors & LE; 20 mm in diameter and in the adenocarcinoma subgroups. Low performance status, male sex, and pulmonary interstitial changes were poor prognostic factors for overall survival. This real-world evidence will be useful in shared decision-making for optimal treatment, including SBRT for operable stage I NSCLC, particularly in older patients.Abstract Surgery is the standard treatment for stage I non-small cell lung cancer (NSCLC); however, no clear randomized trial demonstrates its superiority to stereotactic body radiotherapy (SBRT) regarding survival. We aimed to retrospectively evaluate the treatment outcomes of SBRT in operable patients with stage I NSCLC using a large Japanese multi-institutional database to show real-world outcome. Exactly 399 patients (median age 75 years; 262 males and 137 females) with stage I (IA 292, IB 107) histologically proven NSCLC (adenocarcinoma 267, squamous cell carcinoma 96, others 36) treated at 20 institutions were reviewed. SBRT was prescribed at a total dose of 48-70 Gy in 4-10 fractions. The median follow-up period was 38 months. Local progression-free survival rates were 84.2% in all patients and 86.1% in the T1, 78.6% in T2, 89.2% in adenocarcinoma, and 70.5% in squamous cell subgroups. Overall 3-year survival rates were 77.0% in all patients: 90.7% in females, 69.6% in males, and 41.2% in patients with pulmonary interstitial changes. Fatal radiation pneumonitis was observed in two patients, all of whom had pulmonary interstitial changes. This real-world evidence will be useful in shared decision-making for optimal treatment, including SBRT for operable stage I NSCLC, particularly in older patients.

引用

页数：13

共 35 条

[1]

[Anonymous], 2023, clinical practice guidelines in oncology (NCCN Guidelines) lung cancer screening version 2

[2] A systematic review and meta-analysis of stereotactic body radiation therapy versus surgery for patients with non-small cell lung cancer [J].

Cao, Christopher ;

Wang, Daniel ;

Chung, Caroline ;

Tian, David ;

Rimner, Andreas ;

Huang, James ;

Jones, David R. .

JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2019, 157 (01) :362-+

[3] Stereotactic ablative radiotherapy for operable stage I non-small-cell lung cancer (revised STARS): long-term results of a single-arm, prospective trial with prespecified comparison to surgery [J].

Chang, Joe Y. ;

Mehran, Reza J. ;

Feng, Lei ;

Verma, Vivek ;

Liao, Zhongxing ;

Welsh, James W. ;

Lin, Steven H. ;

O'Reilly, Michael S. ;

Jeter, Melenda D. ;

Balter, Peter A. ;

McRae, Stephen E. ;

Berry, Donald ;

Heymach, John, V ;

Roth, Jack A. .

LANCET ONCOLOGY, 2021, 22 (10) :1448-1457

[4] Stereotactic ablative radiotherapy versus lobectomy for operable stage I non-small-cell lung cancer: a pooled analysis of two randomised trials [J].

Chang, Joe Y. ;

Senan, Suresh ;

Paul, Marinus A. ;

Mehran, Reza J. ;

Louie, Alexander V. ;

Balter, Peter ;

Groen, Harry J. M. ;

McRae, Stephen E. ;

Widder, Joachim ;

Feng, Lei ;

van den Borne, Ben E. E. M. ;

Munsell, Mark F. ;

Hurkmans, Coen ;

Berry, Donald A. ;

van Werkhoven, Erik ;

Kresl, John J. ;

Dingemans, Anne-Marie ;

Dawood, Omar ;

Haasbeek, Cornelis J. A. ;

Carpenter, Larry S. ;

De Jaeger, Katrien ;

Komaki, Ritsuko ;

Slotman, Ben J. ;

Smit, Egbert F. ;

Roth, Jack A. .

LANCET ONCOLOGY, 2015, 16 (06) :630-637

[5] Quality of Life After Stereotactic Ablative Radiotherapy for Early-Stage Lung Cancer: A Systematic Review [J].

Chen, Hanbo ;

Louie, Alexander V. ;

Boldt, R. Gabriel ;

Rodrigues, George B. ;

Palma, David A. ;

Senan, Suresh .

CLINICAL LUNG CANCER, 2016, 17 (05) :E141-E149

[6] Trends and variations in treatment of stage I?III non-small cell lung cancer from 2008 to 2018: A nationwide population-based study from the Netherlands [J].

Evers, Jelle ;

de Jaeger, Katrien ;

Hendriks, Lizza E. L. ;

van der Sangen, Maurice ;

Terhaard, Chris ;

Siesling, Sabine ;

De Ruysscher, Dirk ;

Struikmans, Henk ;

Aarts, Mieke J. .

LUNG CANCER, 2021, 155 :103-113

[7] Outcomes after Stereotactic Body Radiotherapy versus Limited Resection in Older Patients with Early-Stage Lung Cancer [J].

Ezer, Nicole ;

Veluswamy, Rajwanth R. ;

Mhango, Grace ;

Rosenzweig, Kenneth E. ;

Powell, Charles A. ;

Wisnivesky, Juan P. .

JOURNAL OF THORACIC ONCOLOGY, 2015, 10 (08) :1201-1206

[8] Real-World Evidence of Health Outcomes Related to Lung Stereotactic Body Radiation Therapy in Brazil [J].

Faroni, Lilian ;

Ferreira, Carlos Gil ;

Moraes, Fabio ;

Baldotto, Clarissa ;

Zukin, Mauro ;

Aran, Veronica ;

Araujo, Luiz Henrique .

JCO GLOBAL ONCOLOGY, 2022, 8 :e2200061

[9] The use of surgery to treat lung cancer in elderly patients [J].

Jaklitsch, MT ;

Mery, CM ;

Audisio, RA .

LANCET ONCOLOGY, 2003, 4 (08) :463-471

[10] Patterns of Use of Stereotactic Body Radiation Therapy Compared With Surgery for Definitive Treatment of Primary Early-stage Non-small Cell Lung Cancer [J].

Jang, Julie K. ;

Atay, Scott M. ;

Ding, Li ;

David, Elizabeth A. ;

Wightman, Sean C. ;

Kim, Anthony W. ;

Ye, Jason C. .

AMERICAN JOURNAL OF CLINICAL ONCOLOGY-CANCER CLINICAL TRIALS, 2022, 45 (04) :146-154

← 1 2 3 4 →