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Treatment of T3N0 non-small cell lung cancer with chest wall invasion using stereotactic body radiotherapy

OBJECTIVES: Chest wall invasion (CWI) is observed in 5% of localized non-small cell lung cancer (NSCLC). The role of stereotactic body radiotherapy (SBRT) in these patients is unknown. We investigate the safety and efficacy of SBRT in patients with T3N0 NSCLC due to CWI. METHODS: Patients with T3N0...

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Autores principales: Kennedy, William R., Gabani, Prashant, Nikitas, John, Samson, Pamela P., Robinson, Clifford G., Bradley, Jeffrey D., Roach, Michael C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6396077/
https://www.ncbi.nlm.nih.gov/pubmed/30859139
http://dx.doi.org/10.1016/j.ctro.2019.02.004
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author Kennedy, William R.
Gabani, Prashant
Nikitas, John
Samson, Pamela P.
Robinson, Clifford G.
Bradley, Jeffrey D.
Roach, Michael C.
author_facet Kennedy, William R.
Gabani, Prashant
Nikitas, John
Samson, Pamela P.
Robinson, Clifford G.
Bradley, Jeffrey D.
Roach, Michael C.
author_sort Kennedy, William R.
collection PubMed
description OBJECTIVES: Chest wall invasion (CWI) is observed in 5% of localized non-small cell lung cancer (NSCLC). The role of stereotactic body radiotherapy (SBRT) in these patients is unknown. We investigate the safety and efficacy of SBRT in patients with T3N0 NSCLC due to CWI. METHODS: Patients with T3N0 NSCLC due to CWI were identified using a prospective registry. CWI was defined as radiographic evidence of soft tissue invasion or bony destruction. We excluded patients with recurrent or metastatic disease. All patients were treated with definitive SBRT. Prescribed dose was 50 Gy in 5 fractions for most patients. Kaplan-Meier analysis was used to estimate survival outcomes. RESULTS: We identified 12 patients treated between 2006 and 2017. Median age was 70 (range, 58–85). Median tumor diameter was 3.0 cm (range, 0.9–7.2). Median survival was 12.0 months (range, 2.4–63). At a median follow-up of 8.9 months (range, 2.1–63), 1-year primary tumor control was 89%, involved lobar control was 89%, local–regional control was 82%, distant control was 91%, and survival was 63%. Of the 4 patients with pre-treatment chest wall pain, 3 reported improvement after SBRT. Two patients reported new grade 1–2 chest wall pain. No grade 3+ toxicity was reported, with 1 patient experiencing grade 1 skin toxicity and 3 patients experiencing grade 1–2 radiation pneumonitis. CONCLUSIONS: SBRT for CWI NSCLC is safe, with high early tumor control and low treatment-related toxicity. Most patients with pre-treatment chest wall pain experienced relief after SBRT, with no grade 3+ toxicity observed.
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spelling pubmed-63960772019-03-11 Treatment of T3N0 non-small cell lung cancer with chest wall invasion using stereotactic body radiotherapy Kennedy, William R. Gabani, Prashant Nikitas, John Samson, Pamela P. Robinson, Clifford G. Bradley, Jeffrey D. Roach, Michael C. Clin Transl Radiat Oncol Article OBJECTIVES: Chest wall invasion (CWI) is observed in 5% of localized non-small cell lung cancer (NSCLC). The role of stereotactic body radiotherapy (SBRT) in these patients is unknown. We investigate the safety and efficacy of SBRT in patients with T3N0 NSCLC due to CWI. METHODS: Patients with T3N0 NSCLC due to CWI were identified using a prospective registry. CWI was defined as radiographic evidence of soft tissue invasion or bony destruction. We excluded patients with recurrent or metastatic disease. All patients were treated with definitive SBRT. Prescribed dose was 50 Gy in 5 fractions for most patients. Kaplan-Meier analysis was used to estimate survival outcomes. RESULTS: We identified 12 patients treated between 2006 and 2017. Median age was 70 (range, 58–85). Median tumor diameter was 3.0 cm (range, 0.9–7.2). Median survival was 12.0 months (range, 2.4–63). At a median follow-up of 8.9 months (range, 2.1–63), 1-year primary tumor control was 89%, involved lobar control was 89%, local–regional control was 82%, distant control was 91%, and survival was 63%. Of the 4 patients with pre-treatment chest wall pain, 3 reported improvement after SBRT. Two patients reported new grade 1–2 chest wall pain. No grade 3+ toxicity was reported, with 1 patient experiencing grade 1 skin toxicity and 3 patients experiencing grade 1–2 radiation pneumonitis. CONCLUSIONS: SBRT for CWI NSCLC is safe, with high early tumor control and low treatment-related toxicity. Most patients with pre-treatment chest wall pain experienced relief after SBRT, with no grade 3+ toxicity observed. Elsevier 2019-02-21 /pmc/articles/PMC6396077/ /pubmed/30859139 http://dx.doi.org/10.1016/j.ctro.2019.02.004 Text en © 2019 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Article
Kennedy, William R.
Gabani, Prashant
Nikitas, John
Samson, Pamela P.
Robinson, Clifford G.
Bradley, Jeffrey D.
Roach, Michael C.
Treatment of T3N0 non-small cell lung cancer with chest wall invasion using stereotactic body radiotherapy
title Treatment of T3N0 non-small cell lung cancer with chest wall invasion using stereotactic body radiotherapy
title_full Treatment of T3N0 non-small cell lung cancer with chest wall invasion using stereotactic body radiotherapy
title_fullStr Treatment of T3N0 non-small cell lung cancer with chest wall invasion using stereotactic body radiotherapy
title_full_unstemmed Treatment of T3N0 non-small cell lung cancer with chest wall invasion using stereotactic body radiotherapy
title_short Treatment of T3N0 non-small cell lung cancer with chest wall invasion using stereotactic body radiotherapy
title_sort treatment of t3n0 non-small cell lung cancer with chest wall invasion using stereotactic body radiotherapy
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6396077/
https://www.ncbi.nlm.nih.gov/pubmed/30859139
http://dx.doi.org/10.1016/j.ctro.2019.02.004
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