Purpose/Objectives: Medically inoperable lung cancer patients often have comorbidities that preclude pathologic diagnosis from being attained. We perform a multi-institutional analysis to determine if unbiopsied early stage lung carcinoma can be safely and effectively treated with SBRT.Material/Methods: 34 patients with unbiopsied lung cancer treated with SBRT at the University of Louisville or University of Virginia. Patients had CT and PET imaging clinically consistent with lung malignancy. Median SBRT dose was 50 Gy (range 30-55 Gy) in a median of 5 fractions (range 3-10 fractions) with static field SBRT or VMAT.Results: Median follow up is 16.7 months. Primary tumors had a median longest dimension on the original CT of 1.6 cm (range 0.5-3.3 cm) and post-treatment CT scan of 1.25 cm (range 0.0-4.5 cm) (p=0.025). Median pretreatment SUV on initial PET scan is 4.6 (range 0.0-16.2) and at a median of 7.6 months after SBRT, decreased to 2.25 (range 0.0-10.9) on post-treatment PET (p=0.002). Crude local control is 97.1%. The estimated 2 year regional control is 80%, distant control 85%, and overall survival 85%. There were no Grade 3 or greater acute toxicities and only three Grade 3 chronic treatment-related toxicitities.Conclusions: In medically inoperable patients with unbiopsied lung cancer, local control can be achieved in with minimal toxicity with the use of SBRT. The use of SBRT for unbiopsied early stage lung cancer patients should be performed in a multidisciplinary setting and after detailed discussion with the patient about risks and benefits of SBRT.
Harkenrider, M,
Stereotactic Body Radiation Therapy for Unbiopsied Early Stage Lung Cancer - A Multi-institutional Analysis. Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL.
http://archive.rsna.org/2013/13043468.html
