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Stereotactic Body Radiation Therapy Is Effective and Safe in Patients with Early-Stage Non-Small Cell Lung Cancer with Low Performance Status and Severe Comorbidity

BACKGROUND: The purpose of this study was to assess stereotactic body radiation therapy (SBRT) results and toxicity for stage I non-small cell lung cancer patients with low performance status and severe comorbidity. PATIENTS AND METHODS: From September 2008 to April 2010, 36 patients with 38 lesions...

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Autores principales: Turzer, Martin, Brustugun, Odd Terje, Waldeland, Einar, Helland, Åslaug
Formato: Texto
Lenguaje:English
Publicado: S. Karger AG 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3082486/
https://www.ncbi.nlm.nih.gov/pubmed/21526003
http://dx.doi.org/10.1159/000324113
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author Turzer, Martin
Brustugun, Odd Terje
Waldeland, Einar
Helland, Åslaug
author_facet Turzer, Martin
Brustugun, Odd Terje
Waldeland, Einar
Helland, Åslaug
author_sort Turzer, Martin
collection PubMed
description BACKGROUND: The purpose of this study was to assess stereotactic body radiation therapy (SBRT) results and toxicity for stage I non-small cell lung cancer patients with low performance status and severe comorbidity. PATIENTS AND METHODS: From September 2008 to April 2010, 36 patients with 38 lesions were treated with hypofractionated SBRT. All except one were medically inoperable, had low performance status and/or severe cardiovascular and/or cardiopulmonary comorbidity. The patients were immobilized in an Elekta stereotactic body frame to improve setup accuracy, and four-dimensional CT scans were used for target delineation. Fractions of 15 Gy were prescribed to cover the planning target volume, giving a total dose of 45 Gy, with 1 fraction every second day. Cone beam CT was applied at each fraction to correct for setup errors. The patients were followed with toxicity evaluation and radiographic follow-up. RESULTS: Median follow-up time was 13.8 months (0–21 months). The local tumor control after 12 months was 100%. Four patients developed regional relapse about 12 months after SBRT. The 1-year disease-free survival was 83%. The median tumor shrinkage at 1 year was 22 mm. Three patients experienced systemic relapse after 13 months. One patient developed grade 3 chest pain toxicity and 16 patients reported temporary grade 1 chest pain toxicity. Two patients reported temporary increased dyspnea. No patient experienced a reduction of the performance status after SBRT. CONCLUSION: SBRT is an effective and safe treatment modality for elderly patients with early-stage non-small cell lung cancer, having low performance status and severe comorbidity. It is possible to achieve high local control rates with good tolerance.
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spelling pubmed-30824862011-04-27 Stereotactic Body Radiation Therapy Is Effective and Safe in Patients with Early-Stage Non-Small Cell Lung Cancer with Low Performance Status and Severe Comorbidity Turzer, Martin Brustugun, Odd Terje Waldeland, Einar Helland, Åslaug Case Rep Oncol Published: January 2011 BACKGROUND: The purpose of this study was to assess stereotactic body radiation therapy (SBRT) results and toxicity for stage I non-small cell lung cancer patients with low performance status and severe comorbidity. PATIENTS AND METHODS: From September 2008 to April 2010, 36 patients with 38 lesions were treated with hypofractionated SBRT. All except one were medically inoperable, had low performance status and/or severe cardiovascular and/or cardiopulmonary comorbidity. The patients were immobilized in an Elekta stereotactic body frame to improve setup accuracy, and four-dimensional CT scans were used for target delineation. Fractions of 15 Gy were prescribed to cover the planning target volume, giving a total dose of 45 Gy, with 1 fraction every second day. Cone beam CT was applied at each fraction to correct for setup errors. The patients were followed with toxicity evaluation and radiographic follow-up. RESULTS: Median follow-up time was 13.8 months (0–21 months). The local tumor control after 12 months was 100%. Four patients developed regional relapse about 12 months after SBRT. The 1-year disease-free survival was 83%. The median tumor shrinkage at 1 year was 22 mm. Three patients experienced systemic relapse after 13 months. One patient developed grade 3 chest pain toxicity and 16 patients reported temporary grade 1 chest pain toxicity. Two patients reported temporary increased dyspnea. No patient experienced a reduction of the performance status after SBRT. CONCLUSION: SBRT is an effective and safe treatment modality for elderly patients with early-stage non-small cell lung cancer, having low performance status and severe comorbidity. It is possible to achieve high local control rates with good tolerance. S. Karger AG 2011-01-21 /pmc/articles/PMC3082486/ /pubmed/21526003 http://dx.doi.org/10.1159/000324113 Text en Copyright © 2011 by S. Karger AG, Basel http://creativecommons.org/licenses/by-nc-nd/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial-No-Derivative-Works License (http://creativecommons.org/licenses/by-nc-nd/3.0/). Users may download, print and share this work on the Internet for noncommercial purposes only, provided the original work is properly cited, and a link to the original work on http://www.karger.com and the terms of this license are included in any shared versions.
spellingShingle Published: January 2011
Turzer, Martin
Brustugun, Odd Terje
Waldeland, Einar
Helland, Åslaug
Stereotactic Body Radiation Therapy Is Effective and Safe in Patients with Early-Stage Non-Small Cell Lung Cancer with Low Performance Status and Severe Comorbidity
title Stereotactic Body Radiation Therapy Is Effective and Safe in Patients with Early-Stage Non-Small Cell Lung Cancer with Low Performance Status and Severe Comorbidity
title_full Stereotactic Body Radiation Therapy Is Effective and Safe in Patients with Early-Stage Non-Small Cell Lung Cancer with Low Performance Status and Severe Comorbidity
title_fullStr Stereotactic Body Radiation Therapy Is Effective and Safe in Patients with Early-Stage Non-Small Cell Lung Cancer with Low Performance Status and Severe Comorbidity
title_full_unstemmed Stereotactic Body Radiation Therapy Is Effective and Safe in Patients with Early-Stage Non-Small Cell Lung Cancer with Low Performance Status and Severe Comorbidity
title_short Stereotactic Body Radiation Therapy Is Effective and Safe in Patients with Early-Stage Non-Small Cell Lung Cancer with Low Performance Status and Severe Comorbidity
title_sort stereotactic body radiation therapy is effective and safe in patients with early-stage non-small cell lung cancer with low performance status and severe comorbidity
topic Published: January 2011
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3082486/
https://www.ncbi.nlm.nih.gov/pubmed/21526003
http://dx.doi.org/10.1159/000324113
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