In a nutshell
This article investigated the safety and effectiveness of stereotactic body radiotherapy (SBRT) for centrally located non-small cell lung cancer (NSCLC).
The authors concluded that SBRT is safe and effective for these patients.
NSCLC is the most common kind of lung cancer. Patients with inoperable NSCLC are usually treated with radiotherapy. However, patients that have tumors centrally located in their lungs often experience high toxicity levels.
An alternative is to treat these patients with SBRT. This involves high doses of radiation from different angles targeted at the tumor. Whether SBRT is less toxic for patients with centrally located NSCLC and what is the safest dose remains under investigation.
Methods & findings
The study involved 100 patients with centrally-located NSCLC. They were given SBRT between 10-12 Gy (measurement unit for radiation) per session over 1.5-2 weeks. They were followed up at 37.9 months.
5 patients experienced toxicity from SBRT including death, slow heart rate, decreased oxygen, lung infection and fluid collecting in the lung. The maximum tolerated dose (MTD) was 12 Gy. 71 of the patients received the two highest doses of SBRT, 11.5 and 12.0 Gy. Group 11.5 Gy had 89.4% local control (total and permanent disappearance of the cancer from its original site). Group 12.0 Gy had 87.9% local control.
The overall survival rate for group 11.5 Gy was 67.9% and for group 12.0 Gy was 72.7%. The survival rate without cancer getting worse in group 11.5 Gy was 52.2% and in group 12.0 was 54.5%. Side effects included gut, heart, weight and lung problems.
The bottom line
The authors concluded that SBRT is safe and effective for patients with centrally-located NSCLC.
The fine print
This study involved a small number of patients. Also, some data regarding radiation doses was missing. this might have influenced the results.
Published By :
Journal of clinical oncology
Apr 03, 2019