Radiation Oncology Journal

The Korean Society for Radiation Oncology (대한방사선종양학회)
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Stereotactic radiotherapy for early stage non-small cell lung cancer

  • Received : 2015.06.12
  • Accepted : 2015.06.17
  • Published : 2015.06.30
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Abstract

Stereotactic body radiotherapy (SBRT) represents a consolidated treatment option for patients with medically inoperable early stage non-small cell lung cancer (NSCLC). The clinical evidence accumulated in the past decade supports its use as an alternative to surgery with comparable survival outcomes. Due to its limited toxicity, SBRT is also applicable to elderly patients with very poor baseline pulmonary function or other severe comorbidities. Recent comparative studies in operable patients raised the issue of the possible use of SBRT also for this subgroup, with quite promising results that still should be fully confirmed by prospective trials with long-term follow-up. Aim of this review is to summarize and discuss the major studies conducted over the years on SBRT and to provide data on the efficacy and toxicity of this radiotherapy technique for stage I NSCLC. Technical aspects and quality of life related issues are also discussed, with the goal to provide information on the current role and limitations of SBRT in clinical practice.

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References

  1. Asamura H. Treatment of choice for stage I non-small cell lung cancer: surgery or radiotherapy? J Thorac Oncol 2006;1:766-7. https://doi.org/10.1016/S1556-0864(15)30403-2
  2. Wisnivesky JP, Bonomi M, Henschke C, Iannuzzi M, McGinn T. Radiation therapy for the treatment of unresected stage I-II non-small cell lung cancer. Chest 2005;128:1461-7. https://doi.org/10.1378/chest.128.3.1461
  3. Blomgren H, Lax I, Naslund I, Svanstrom R. Stereotactic high dose fraction radiation therapy of extracranial tumors using an accelerator: clinical experience of the first thirty-one patients. Acta Oncol 1995;34:861-70. https://doi.org/10.3109/02841869509127197
  4. Uematsu M, Shioda A, Tahara K, et al. Focal, high dose, and fractionated modified stereotactic radiation therapy for lung carcinoma patients: a preliminary experience. Cancer 1998;82:1062-70. https://doi.org/10.1002/(SICI)1097-0142(19980315)82:6<1062::AID-CNCR8>3.0.CO;2-G
  5. Wulf J, Hadinger U, Oppitz U, Olshausen B, Flentje M. Stereotactic radiotherapy of extracranial targets: CT-simulation and accuracy of treatment in the stereotactic body frame. Radiother Oncol 2000;57:225-36. https://doi.org/10.1016/S0167-8140(00)00226-7
  6. Timmerman R, Papiez L, McGarry R, et al. Extracranial stereotactic radioablation: results of a phase I study in medically inoperable stage I non-small cell lung cancer. Chest 2003;124:1946-55. https://doi.org/10.1378/chest.124.5.1946
  7. Senan S, Guckemberger M, Ricardi U. Stage I non-small cell lung cancer and oligometastatic disease. In: Pass HI, Ball D, Scagliotti GV, editors. IASLC textbook multidisciplinary approach to thoracic oncology textbook. Aurora, CO: International Association for the study of Lung Cancer; 2014.
  8. Haasbeek CJ, Lagerwaard FJ, Antonisse ME, Slotman BJ, Senan S. Stage I nonsmall cell lung cancer in patients aged $\geq$75 years: outcomes after stereotactic radiotherapy. Cancer 2010;116:406-14. https://doi.org/10.1002/cncr.24759
  9. Palma D, Visser O, Lagerwaard FJ, Belderbos J, Slotman BJ, Senan S. Impact of introducing stereotactic lung radiotherapy for elderly patients with stage I non-small-cell lung cancer: a population-based time-trend analysis. J Clin Oncol 2010;28:5153-9. https://doi.org/10.1200/JCO.2010.30.0731
  10. Shirvani SM, Jiang J, Chang JY, et al. Comparative effectiveness of 5 treatment strategies for early-stage non-small cell lung cancer in the elderly. Int J Radiat Oncol Biol Phys 2012;84:1060-70. https://doi.org/10.1016/j.ijrobp.2012.07.2354
  11. Hayashi S, Tanaka H, Kajiura Y, Ohno Y, Hoshi H. Stereotactic body radiotherapy for very elderly patients (age, greater than or equal to 85 years) with stage I non-small cell lung cancer. Radiat Oncol 2014;9:138. https://doi.org/10.1186/1748-717X-9-138
  12. McGarry RC, Papiez L, Williams M, Whitford T, Timmerman RD. Stereotactic body radiation therapy of early-stage non-smallcell lung carcinoma: phase I study. Int J Radiat Oncol Biol Phys 2005;63:1010-5. https://doi.org/10.1016/j.ijrobp.2005.03.073
  13. Hoyer M, Roed H, Hansen AT, et al. Prospective study on stereotactic radiotherapy of limited-stage non-small-cell lung cancer. Int J Radiat Oncol Biol Phys 2006;66:S128-S135.
  14. Baumann P, Nyman J, Hoyer M, et al. Outcome in a prospective phase II trial of medically inoperable stage I non-small-cell lung cancer patients treated with stereotactic body radiotherapy. J Clin Oncol 2009;27:3290-6. https://doi.org/10.1200/JCO.2008.21.5681
  15. Timmerman R, Paulus R, Galvin J, et al. Stereotactic body radiation therapy for inoperable early stage lung cancer. JAMA 2010;303:1070-6. https://doi.org/10.1001/jama.2010.261
  16. Ricardi U, Filippi AR, Guarneri A, et al. Stereotactic body radiation therapy for early stage non-small cell lung cancer: results of a prospective trial. Lung Cancer 2010;68:72-7. https://doi.org/10.1016/j.lungcan.2009.05.007
  17. Bral S, Gevaert T, Linthout N, et al. Prospective, risk-adapted strategy of stereotactic body radiotherapy for early-stage non-small-cell lung cancer: results of a phase II trial. Int J Radiat Oncol Biol Phys 2011;80:1343-9. https://doi.org/10.1016/j.ijrobp.2010.04.056
  18. Sibley GS, Jamieson TA, Marks LB, Anscher MS, Prosnitz LR. Radiotherapy alone for medically inoperable stage I nonsmall- cell lung cancer: the Duke experience. Int J Radiat Oncol Biol Phys 1998;40:149-54. https://doi.org/10.1016/S0360-3016(97)00589-0
  19. Onishi H, Araki T, Shirato H, et al. Stereotactic hypofractionated high-dose irradiation for stage I nonsmall cell lung carcinoma: clinical outcomes in 245 subjects in a Japanese multiinstitutional study. Cancer 2004;101:1623-31. https://doi.org/10.1002/cncr.20539
  20. Kestin L, Grills I, Guckenberger M, et al. Dose-response relationship with clinical outcome for lung stereotactic body radiotherapy (SBRT) delivered via online image guidance. Radiother Oncol 2014;110:499-504. https://doi.org/10.1016/j.radonc.2014.02.002
  21. Zhang J, Yang F, Li B, et al. Which is the optimal biologically effective dose of stereotactic body radiotherapy for stage I non-small-cell lung cancer? A meta-analysis. Int J Radiat Oncol Biol Phys 2011;81:e305-16. https://doi.org/10.1016/j.ijrobp.2011.04.034
  22. Koshy M, Malik R, Weichselbaum RR, Sher DJ. Increasing radiation therapy dose is associated with improved survival in patients undergoing stereotactic body radiation therapy for stage I non-small-cell lung cancer. Int J Radiat Oncol Biol Phys 2015;91:344-50. https://doi.org/10.1016/j.ijrobp.2014.10.002
  23. Timmerman R, McGarry R, Yiannoutsos C, et al. Excessive toxicity when treating central tumors in a phase II study of stereotactic body radiation therapy for medically inoperable early-stage lung cancer. J Clin Oncol 2006;24:4833-9. https://doi.org/10.1200/JCO.2006.07.5937
  24. Lagerwaard FJ, Haasbeek CJ, Smit EF, Slotman BJ, Senan S. Outcomes of risk-adapted fractionated stereotactic radiotherapy for stage I non-small-cell lung cancer. Int J Radiat Oncol Biol Phys 2008;70:685-92. https://doi.org/10.1016/j.ijrobp.2007.10.053
  25. Guckenberger M, Allgauer M, Appold S, et al. Safety and efficacy of stereotactic body radiotherapy for stage 1 nonsmall- cell lung cancer in routine clinical practice: a patternsof- care and outcome analysis. J Thorac Oncol 2013;8:1050-8. https://doi.org/10.1097/JTO.0b013e318293dc45
  26. Ricardi U, Frezza G, Filippi AR, et al. Stereotactic ablative radiotherapy for stage I histologically proven non-small cell lung cancer: an Italian multicenter observational study. Lung Cancer 2014;84:248-53. https://doi.org/10.1016/j.lungcan.2014.02.015
  27. Senthi S, Lagerwaard FJ, Haasbeek CJ, Slotman BJ, Senan S. Patterns of disease recurrence after stereotactic ablative radiotherapy for early stage non-small-cell lung cancer: a retrospective analysis. Lancet Oncol 2012;13:802-9. https://doi.org/10.1016/S1470-2045(12)70242-5
  28. Andratschke N, Zimmermann F, Boehm E, et al. Stereotactic radiotherapy of histologically proven inoperable stage I nonsmall cell lung cancer: patterns of failure. Radiother Oncol 2011;101:245-9. https://doi.org/10.1016/j.radonc.2011.06.009
  29. Nyman J, Hallqvist A, Lund JA, et al. SPACE: a randomized study of SBRT vs conventional fractionated radiotherapy in medically inoperable stage I NSCLC. Proceeding of ESTRO 33; 2014 Apr 4-8; Vienna, Austria.
  30. Ginsberg RJ, Rubinstein LV. Randomized trial of lobectomy versus limited resection for T1 N0 non-small cell lung cancer. Ann Thorac Surg 1995;60:615-23. https://doi.org/10.1016/0003-4975(95)00537-U
  31. Landreneau RJ, Normolle DP, Christie NA, et al. Recurrence and survival outcomes after anatomic segmentectomy versus lobectomy for clinical stage I non-small-cell lung cancer: a propensity-matched analysis. J Clin Oncol 2014;32:2449-55. https://doi.org/10.1200/JCO.2013.50.8762
  32. Tsutani Y, Miyata Y, Nakayama H, et al. Oncologic outcomes of segmentectomy compared with lobectomy for clinical stage IA lung adenocarcinoma: propensity score-matched analysis in a multicenter study. J Thorac Cardiovasc Surg 2013;146:358-64. https://doi.org/10.1016/j.jtcvs.2013.02.008
  33. Grills IS, Mangona VS, Welsh R, et al. Outcomes after stereotactic lung radiotherapy or wedge resection for stage I non-small-cell lung cancer. J Clin Oncol 2010;28:928-35. https://doi.org/10.1200/JCO.2009.25.0928
  34. Crabtree TD, Denlinger CE, Meyers BF, et al. Stereotactic body radiation therapy versus surgical resection for stage I nonsmall cell lung cancer. J Thorac Cardiovasc Surg 2010;140:377-86. https://doi.org/10.1016/j.jtcvs.2009.12.054
  35. Verstegen NE, Oosterhuis JW, Palma DA, et al. Stage I-II non-small-cell lung cancer treated using either stereotactic ablative radiotherapy (SABR) or lobectomy by video-assisted thoracoscopic surgery (VATS): outcomes of a propensity scorematched analysis. Ann Oncol 2013;24:1543-8. https://doi.org/10.1093/annonc/mdt026
  36. Shirvani SM, Jiang J, Chang JY, et al. Lobectomy, sublobar resection, and stereotactic ablative radiotherapy for earlystage non-small cell lung cancers in the elderly. JAMA Surg 2014;149:1244-53. https://doi.org/10.1001/jamasurg.2014.556
  37. Mokhles S, Verstegen N, Maat AP, et al. Comparison of clinical outcome of stage I non-small cell lung cancer treated surgically or with stereotactic radiotherapy: results from propensity score analysis. Lung Cancer 2015;87:283-9. https://doi.org/10.1016/j.lungcan.2015.01.005
  38. Onishi H, Shirato H, Nagata Y, et al. Stereotactic body radiotherapy (SBRT) for operable stage I non-small-cell lung cancer: can SBRT be comparable to surgery? Int J Radiat Oncol Biol Phys 2011;81:1352-8. https://doi.org/10.1016/j.ijrobp.2009.07.1751
  39. Lagerwaard FJ, Verstegen NE, Haasbeek CJ, et al. Outcomes of stereotactic ablative radiotherapy in patients with potentially operable stage I non-small cell lung cancer. Int J Radiat Oncol Biol Phys 2012;83:348-53. https://doi.org/10.1016/j.ijrobp.2011.06.2003
  40. Chang JY, Senan S, Paul MA, et al. Stereotactic ablative radiotherapy versus lobectomy for operable stage I non-smallcell lung cancer: a pooled analysis of two randomised trials. Lancet Oncol 2015;16:630-7. https://doi.org/10.1016/S1470-2045(15)70168-3
  41. Grills IS, Hope AJ, Guckenberger M, et al. A collaborative analysis of stereotactic lung radiotherapy outcomes for earlystage non-small-cell lung cancer using daily online cone-beam computed tomography image-guided radiotherapy. J Thorac Oncol 2012;7:1382-93. https://doi.org/10.1097/JTO.0b013e318260e00d
  42. Ueki N, Matsuo Y, Togashi Y, et al. Impact of pretreatment interstitial lung disease on radiation pneumonitis and survival after stereotactic body radiation therapy for lung cancer. J Thorac Oncol 2015;10:116-25. https://doi.org/10.1097/JTO.0000000000000359
  43. Guckenberger M, Kestin LL, Hope AJ, et al. Is there a lower limit of pretreatment pulmonary function for safe and effective stereotactic body radiotherapy for early-stage non-small cell lung cancer? J Thorac Oncol 2012;7:542-51. https://doi.org/10.1097/JTO.0b013e31824165d7
  44. Stanic S, Paulus R, Timmerman RD, et al. No clinically significant changes in pulmonary function following stereotactic body radiation therapy for early- stage peripheral non-small cell lung cancer: an analysis of RTOG 0236. Int J Radiat Oncol Biol Phys 2014;88:1092-9. https://doi.org/10.1016/j.ijrobp.2013.12.050
  45. Lagerwaard FJ, Aaronson NK, Gundy CM, Haasbeek CJ, Slotman BJ, Senan S. Patient-reported quality of life after stereotactic ablative radiotherapy for early-stage lung cancer. J Thorac Oncol 2012;7:1148-54. https://doi.org/10.1097/JTO.0b013e318252cfef
  46. Palma DA, Senan S, Haasbeek CJ, Verbakel WF, Vincent A, Lagerwaard F. Radiological and clinical pneumonitis after stereotactic lung radiotherapy: a matched analysis of threedimensional conformal and volumetric-modulated arc therapy techniques. Int J Radiat Oncol Biol Phys 2011;80:506-13. https://doi.org/10.1016/j.ijrobp.2010.02.032
  47. Kimura T, Matsuura K, Murakami Y, et al. CT appearance of radiation injury of the lung and clinical symptoms after stereotactic body radiation therapy (SBRT) for lung cancers: are patients with pulmonary emphysema also candidates for SBRT for lung cancers? Int J Radiat Oncol Biol Phys 2006;66:483-91. https://doi.org/10.1016/j.ijrobp.2006.05.008
  48. Koenig TR, Munden RF, Erasmus JJ, et al. Radiation injury of the lung after three-dimensional conformal radiation therapy. AJR Am J Roentgenol 2002;178:1383-8. https://doi.org/10.2214/ajr.178.6.1781383
  49. Huang K, Senthi S, Palma DA, et al. High-risk CT features for detection of local recurrence after stereotactic ablative radiotherapy for lung cancer. Radiother Oncol 2013;109:51-7. https://doi.org/10.1016/j.radonc.2013.06.047
  50. Bongers EM, Botticella A, Palma DA, et al. Predictive parameters of symptomatic radiation pneumonitis following stereotactic or hypofractionated radiotherapy delivered using volumetric modulated arcs. Radiother Oncol 2013;109:95-9. https://doi.org/10.1016/j.radonc.2013.10.011

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