Stereotactic body radiation therapy for inoperable early stage lung cancer.

Abstract (PubMed)

CONTEXT: Patients with early stage but medically inoperable lung cancer have a poor rate of primary tumor control (30-40%) and a high rate of mortality (3-year survival, 20-35%). OBJECTIVE: To evaluate the toxicity and efficacy of stereotactic body radiation therapy (SBRT) in a high-risk population. DESIGN: Phase 2 North American multicenter study (RTOG 0236) of patients aged ≥18 years with biopsy-proven peripheral T1-T2N0M0 non-small cell tumors (<5 cm) and medical conditions precluding surgery. Prescription 18 Gy × 3 fractions (54 Gy total). Study open May 2004-October 2006. RESULTS: 59 patients accrued, 55 evaluable (44 T1, 11 T2), median follow-up 34.4 months. 3-year primary tumor control 97.6% (95% CI 84.3-99.7). 3-year survival 55.8%. Grade 3 adverse events 7 patients (12.7%), grade 4 in 2 (3.6%), no grade 5. CONCLUSION: SBRT provides high rates of local tumor control with moderate treatment-related morbidity in medically inoperable NSCLC.