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Safety and effectiveness of stereotactic body radiotherapy for a clinically diagnosed primary stage I lung cancer without pathological confirmation

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Abstract

Background

Pathological diagnosis fails in some pulmonary tumors, although they may be highly suspected to be primary lung cancer. We studied the outcome of stereotactic body radiotherapy for a clinically diagnosed primary stage I lung cancer without pathological confirmation.

Methods

The current study included 37 patients (39 lesions) treated with stereotactic body radiotherapy who were clinically diagnosed with primary stage I lung cancer between August 1998 and April 2009 at our hospital. Pulmonary tumors were highly suspected to be malignant from physical and imaging examinations. Biopsies were performed for 62 % of patients, although malignancy was not pathologically confirmed. In the other 38 % of patients, a biopsy was not feasible. Median age of the patients was 77 years. Median tumor diameter was 20 mm. A total median dose of 48 Gy was prescribed to the isocenter in four fractions. Median follow-up period was 39 months.

Results

The 3-year overall survival, local control, and regional-distant control were 74.2, 94.0, and 68.6 %, respectively. In patients with tumors ≤20 mm, overall survival and regional-distant control were significantly higher than in patients with tumors >20 mm (p ≤ 0.001), whereas no significant difference was observed regarding local control. No grade 3–5 adverse events possibly, probably, or definitely related to the treatment were observed.

Conclusions

Stereotactic body radiotherapy is safe and effective for a clinically diagnosed primary stage I lung cancer when pathological diagnosis is difficult even with repeat biopsies, or a biopsy is not feasible for reasons of the patient’s health condition or wishes.

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Acknowledgments

This work was supported by Grants-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science, and Technology of Japan (20229009).

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Shogoin, Kawahara-cho, Sakyo-ku, Kyoto, Kyoto, Japan

    Katsuyuki Sakanaka, Yukinori Matsuo, Yoshiki Norihisa, Nami Ueki, Takashi Mizowaki & Masahiro Hiraoka

  2. Department of Radiation Oncology, Graduate School of Medical Sciences, Hiroshima University, Kasumi 1-2-3, Hiroshima, Hiroshima, Japan

    Yasushi Nagata

  3. Department of Radiology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, Japan

    Sayo Maki

  4. Department of Therapeutic Radiology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi, Japan

    Keiko Shibuya

  5. Particle Radiation Oncology Research Center, Research Reactor Institute, Kyoto University, 2-1010, Asashiro-nishi, Kumatori-cho, Sennan-gun, Osaka, Japan

    Masaru Narabayashi

Authors
  1. Katsuyuki Sakanaka
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  2. Yukinori Matsuo
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  3. Yasushi Nagata
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  4. Sayo Maki
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  5. Keiko Shibuya
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  6. Yoshiki Norihisa
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  7. Masaru Narabayashi
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  8. Nami Ueki
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  9. Takashi Mizowaki
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  10. Masahiro Hiraoka
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Corresponding author

Correspondence to Yukinori Matsuo.

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Sakanaka, K., Matsuo, Y., Nagata, Y. et al. Safety and effectiveness of stereotactic body radiotherapy for a clinically diagnosed primary stage I lung cancer without pathological confirmation. Int J Clin Oncol 19, 814–821 (2014). https://doi.org/10.1007/s10147-013-0637-3

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  • DOI: https://doi.org/10.1007/s10147-013-0637-3

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