In a nutshell
This study examined whether stereotactic body radiotherapy (SBRT) is a safe and effective treatment for patients with non-small-cell lung cancer (NSCLC) with tumors measuring over 5 cm. The authors concluded that SBRT is safe and effective for these patients.
Some background
Some patients with NSCLC are ineligible for surgery due to other lung or heart problems. These patients are generally treated with stereotactic body radiotherapy (SBRT). SBRT is a type of radiation that is focused directly on the tumor.
There are fewer patients who have large tumors (over 5 cm) compared to those with tumors under 5 cm. Due to this, evidence to support SBRT for inoperable NSCLC has been focused on patients with smaller tumors. There is little evidence available showing the effectiveness of SBRT for patients with large tumors.
Methods & findings
The authors reviewed data from patients who had inoperable NSCLC, with tumors over 5 cm treated with SBRT. There were 92 patients in total. Patients were followed for 12-15 months.
At 3 months post-treatment, 3 patients had a complete response (tumor disappearance), 50 patients had a partial response (greater than 30% decrease in tumor size), 26 patients had stable disease (no change in tumor size) and 2 patients had progressive disease.
The estimated rate of local control (tumor stops growing at the site of origin) was 95.7% after 1 year and 73.2% after 2 years. The disease free survival rate (time between treatment completion and disease recurrence) was 72.1% after 1 year and 53.5% after 2 years. The average overall survival (time from treatment until death from any cause) was 21.4 months.
In total, 34 patients had cancer recurrences. Of all recurrences, 33% were distant (spread to another part of the body), 26% were local (site of tumor origin) and 23% where elsewhere in the lung.
By final follow-up 58 patients had died. 33% of these patients died due to disease progression.
The most common side effect was radiation pneumonitis (inflammation in the lung), which affected 11% of patients. 5 patients experienced more severe side effects. 1 patient had dermatitis and 4 patients had radiation pneumonitis. One patient who continued to smoke after SBRT died of radiation pneumonitis.
The bottom line
The authors concluded that for patients with inoperable NSCLC tumors larger than 5 cm, SBRT is effective and safe.
The fine print
This was a review of previously available data and therefore the treatment was not directly compared to any other type of cancer treatment.
Published By :
Cancer
Date :
Oct 14, 2016
