Stereotactic body radiotherapy for early‑stage non‑small cell lung cancer:: a multicentre study by the Oncologic Group for the Study of Lung Cancer (Spanish Radiation Oncology Society)

• P. Mª Samper Ots ^[1] ; C. Vallejo Ocaña ^[2] ; M. Martin Martin ^[2] ; F. J. Celada Álvarez ^[11] ; D. Farga Albiol ^[11] ; P. Almendros Blanco ^[12] ; A. Hernandez Machancoses ^[12] ; M. Rico Oses ^[13] ; S. Flamarique Andueza ^[13] ; F. Romero Ruperto ^[3] ; C. Maria Bueno ^[3] ; E. Amaya Escobar ^[1] ; L. L. Guerrero Gómez ^[14] ; F. Couñago ^[15] ; Mª del Pino Alcántara ^[4] ; Mª J. Ruiz Villar ^[5] ; J. L. Monroy Antón ^[16] ; P. Saez Bueno ^[17] ; J. Luna Tirado ^[6] ; Mª del Mar Puertas ^[7] ; A. Bobo ^[8] ; I. Diaz de Cerio Martínez ^[9] ; N. Gascon Costoso ^[10] ; C. Ferrer Albiach ^[18]
  1. [1] Hospital Universitario Rey Juan Carlos

     Hospital Universitario Rey Juan Carlos

     Móstoles, España

     
  2. [2] Hospital Ramón y Cajal

     Hospital Ramón y Cajal

     Madrid, España

     
  3. [3] Hospital Universitario Reina Sofia

     Hospital Universitario Reina Sofia

     Cordoba, España

     
  4. [4] Hospital Clínico San Carlos de Madrid

     Hospital Clínico San Carlos de Madrid

     Madrid, España

     
  5. [5] Hospital Universitario La Paz

     Hospital Universitario La Paz

     Madrid, España

     
  6. [6] Fundación Jiménez Díaz

     Fundación Jiménez Díaz

     Madrid, España

     
  7. [7] Hospital Miguel Servet

     Hospital Miguel Servet

     Zaragoza, España

     
  8. [8] Hospital Ruber Internacional

     Hospital Ruber Internacional

     Madrid, España

     
  9. [9] Hospital Universitario Marqués de Valdecilla

     Hospital Universitario Marqués de Valdecilla

     Santander, España

     
  10. [10] Hospital Universitario 12 de Octubre

      Hospital Universitario 12 de Octubre

      Madrid, España

      
  11. [11] Hospital Universitario y Politécnico La Fe, Valencia, Spain
  12. [12] Hospital General de Valencia, Valencia, Spain
  13. [13] Complejo Hospitalario de Navarra, Navarra, Spain
  14. [14] Hospital La Luz Madrid Quironsalud Madrid, Madrid, Spain
  15. [15] Hospital Universitario Quironsalud y Hospital La Luz Quironsalud, Madrid, Spain
  16. [16] Hospital Universitario de la Rivera, Alcira, Valencia, Spain
  17. [17] Hospital Universitario Central de la Defensa “Gómez Ulla”, Madrid, Spain
  18. [18] Complejo Hospitalario Castellón, Castellón, Spain

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• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 24, Nº. 2, 2022, págs. 342-349
• Idioma: inglés
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• Resumen

  • Purpose/objective(s) Stereotactic body radiotherapy (SBRT) has become the standard of care for patients with medically inoperable early-stage non-small cell lung cancer (NSCLC) and for patients who refuse surgery. The aim of this study was to evaluate the effectiveness and safety of primary SBRT in patients with early-stage NSCLC.

    Materials/methods Retrospective multicenter study of 397 patients (416 primary lung tumours) treated with SBRT at 18 centres in Spain. 83.2% were men. The median age was 74.4 years. In 94.4% of cases, the tumour was inoperable. The patho- logical report was available in 54.6% of cases. SPSS vs 22.0. was used to perform all statistical analyses.

    Results Complete response was obtained in 53.6% of cases. Significant prognostic factors were standard CT planning (p = 0.014) and 4D cone beam CT (p = 0.000). Acute and chronic toxicity ≥ grade 3 was observed in 1.2% of cases. At a median follow-up of 30 months, local relapse was 9.6%, lymph node relapse 12.8%, distant metastasis 16.6%, and another lung tumour 11.5%. Complete response was the only significant prognostic factor for local relapse (p = 0.012) and distant metastasis (p = 0.001). The local relapse-free survival was 88.7%. The overall survival was 75.7%. The cancer-specific sur- vival was 92.7%. The disease-free survival was 78.7%.

    Conclusion SBRT is an effective and well-tolerated treatment option for patients with early-stage lung cancer who are not suitable for surgery. The most important prognostic factor for local and distant recurrence was complete response, which in our sample depended on the type of CT planning and the IGRT technique.