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Stereotactic Body Radiation Therapy in the Treatment of Early Stage Non-Small Cell Lung Cancer

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Treating Tumors that Move with Respiration
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Abstract

Lung cancer is a significant cause of morbidity and mortality in the United States, with an estimated 173,000 new lung cancer cases and 156,300 deaths due to lung cancer in 2003 [1]. Eighty-five percent of these patients are diagnosed with non-small cell lung cancer (NSCLC), of which 15–20% will have early stage disease [2]. Treatment options for early stage NSCLC depend on patient factors, such as pulmonary reserve, to determine if a patient is a surgical candidate or not. Typically, standard “cut-off” medical guidelines for surgical resection of NSCLC include the following: baseline forced expiratory volume in 1 s (FEV1) < 40% of predicted, post-operative predicted FEV1 < 30%, severely reduced diffusion capacity, baseline hypoxemia and/or hypercapnia, and exercise oxygen consumption < 50% predicted. For the relatively healthy patient, the traditional treatment of choice for Stage I (T1–2, N0, M0) NSCLC usually consists of radical surgery (lobectomy, pneumonectomy) resulting in an approximate 60% to 80% 5-year overall survival [3]–[5].

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References

  1. Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2006. CA Cancer J Clin 2006;56:106–130.

    Article  PubMed  Google Scholar 

  2. Brown cc, Kessler LG. Projections of lung cancer mortality in the United States: 1985–2025. J Natl Cancer Inst 1988;80:43–51.

    Article  PubMed  CAS  Google Scholar 

  3. AJCC Cancer Staging Manual, 6th Edition. New York: Springer-Verlag; 2002.

    Google Scholar 

  4. Annual Smoking attributable mortality, years of potential life lost and economic costs — United States, 1997–2001. MMWR Morb Mortal Wkly Rep 2005; 54:625–628.

    Google Scholar 

  5. Travis WD, Colby TV, Corrin B, et al., editors. Histologic typing of lung and pleural tumors: World Health Organization Histological Classification of Tumors. 3rd ed. Berlin: Springer-Verlag; 1999.

    Google Scholar 

  6. Martini N, Bains MS, Burt ME, et al. Incidence of local recurrence and second primary tumors in resected stage I lung cancer. J Thorac Cardiovasc Surg 1995;109:120–129.

    Article  PubMed  CAS  Google Scholar 

  7. Ginsberg RJ, Rubinstein LV. Randomized trial of lobectomy versus limited resection for T1 N0 non-small cell lung cancer. Lung Cancer Study Group. Ann Thorac Surg 1995;60:615–622; discussion 622–613.

    Article  PubMed  CAS  Google Scholar 

  8. Chen M, Hayman JA, Ten Haken RK, et al. Long-term results of high-dose conformal radiotherapy for patients with medically inoperable T 1-3N0 non-small-cell lung cancer: is low incidence of regional failure due to incidental nodal irradiation? Int J Radiat Oncol Biol Phys 2006;64:120–126.

    Article  PubMed  Google Scholar 

  9. Qiao X, Tullgren O, Lax I, et al. The role of radiotherapy in treatment of stage I non-small cell lung cancer. Lung Cancer 2003;41:1–11.

    Article  PubMed  Google Scholar 

  10. Cox JD, Azarnia N, Byhardt RW, et al. A randomized phase I/II trial of hyperfractionated radiation therapy with total doses of 60.0 Gy to 79.2 Gy: possible survival benefit with greater than or equal to 69.6 Gy in favorable patients with Radiation Therapy Oncology Group stage III non-small-cell lung carcinoma: report of Radiation Therapy Oncology Group 83-11. J Clin Oncol 1990;8:1543–1555.

    PubMed  CAS  Google Scholar 

  11. Dosoretz DE, Galmarini D, Rubenstein JH, et al. Local control in medically inoperable lung cancer: an analysis of its importance in outcome and factors determining the probability of tumor eradication. Int J Radiat Oncol Biol Phys 1993;27:507–516.

    PubMed  CAS  Google Scholar 

  12. Dosoretz DE, Katin MJ, Blitzer PH, et al. Radiation therapy in the management of medically inoperable carcinoma of the lung: results and implications for future treatment strategies. Int J Radiat Oncol Biol Phys 1992;24:3–9.

    PubMed  CAS  Google Scholar 

  13. Sibley GS, Jamieson TA, Marks LB, et al. Radiotherapy alone for medically inoperable stage I non-small-cell lung cancer: the Duke experience. Int J Radiat Oncol Biol Phys 1998;40:149–154.

    Article  PubMed  CAS  Google Scholar 

  14. Sibley GS. Radiotherapy for patients with medically inoperable Stage I nonsmall cell lung carcinoma: smaller volumes and higher doses-a review. Cancer 1998;82:433–438.

    Article  PubMed  CAS  Google Scholar 

  15. Blomgren H, Lax I, Naslund I, et al. Stereotactic high dose fraction radiation therapy of extracranial tumors using an accelerator. Clinical experience of the first thirty-one patients. Acta Oncol 1995;34:861–870.

    PubMed  CAS  Google Scholar 

  16. Lax I, Blomgren H, Naslund I, et al. Stereotactic radiotherapy of malignancies in the abdomen. Methodological aspects. Acta Oncol 1994;33:677–683.

    PubMed  CAS  Google Scholar 

  17. Giraud P, Antoine M, Larrouy A, et al. Evaluation of microscopic tumor extension in non-small-cell lung cancer for three-dimensional conformal radiotherapy planning. Int J Radiat Oncol Biol Phys 2000;48:1015–1024.

    Article  PubMed  CAS  Google Scholar 

  18. McGarry RC, Papiez L, Williams M, et al. Stereotactic body radiation therapy of early-stage non-small-cell lung carcinoma: phase I study. Int J Radiat Oncol Biol Phys 2005;63:1010–1015.

    Article  PubMed  Google Scholar 

  19. 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;124:1946–1955.

    Article  PubMed  Google Scholar 

  20. Sandler HM, Curran WJ, Jr., Turrisi AT, III. The influence of tumor size and pre-treatment staging on outcome following radiation therapy alone for stage I non-small cell lung cancer. Int J Radiat Oncol Biol Phys 1990;19:9–13.

    PubMed  CAS  Google Scholar 

  21. Martel MK, Ten Haken RK, Hazuka MB, et al. Estimation of tumor control probability model parameters from 3-D dose distributions of non-small cell lung cancer patients. Lung Cancer 1999;24:31–37.

    Article  PubMed  CAS  Google Scholar 

  22. Bradley J, Graham MV, Winter K, et al. Toxicity and outcome results of RTOG 9311: a phase I-II dose-escalation study using three-dimensional conformal radiotherapy in patients with inoperable non-small-cell lung carcinoma. Int J Radiat Oncol Biol Phys 2005;61:318–328.

    Article  PubMed  Google Scholar 

  23. Bradley J. A review of radiation dose escalation trials for non-small cell lung cancer within the Radiation Therapy Oncology Group. Semin Oncol 2005;32:S111–113.

    Article  PubMed  Google Scholar 

  24. Willner J, Baier K, Caragiani E, et al. Dose, volume, and tumor control prediction in primary radiotherapy of non-small-cell lung cancer. Int J Radiat Oncol Biol Phys 2002;52:382–389.

    Article  PubMed  Google Scholar 

  25. Wulf J, Baier K, Mueller G, et al. Dose-response in stereotactic irradiation of lung tumors. Radiother Oncol 2005;77:83–87.

    Article  PubMed  Google Scholar 

  26. Uematsu M, Shioda A, Suda A, et al. Computed tomography-guided frameless stereotactic radiotherapy for stage I non-small cell lung cancer: a 5-year experience. Int J Radiat Oncol Biol Phys 2001;51:666–670.

    Article  PubMed  CAS  Google Scholar 

  27. Fukumoto S, Shirato H, Shimzu S, et al. Small-volume image-guided radiotherapy using hypofractionated, coplanar, and noncoplanar multiple fields for patients with inoperable Stage I nonsmall cell lung carcinomas. Cancer 2002;95:1546–1553.

    Article  PubMed  Google Scholar 

  28. Cheung PC, Mackillop WJ, Dixon P, et al. Involved-field radiotherapy alone for early-stage non-small-cell lung cancer. Int J Radiat Oncol Biol Phys 2000;48:703–710.

    Article  PubMed  CAS  Google Scholar 

  29. Hiraoka M, Nagata Y. Stereotactic body radiation therapy for early-stage non-small-cell lung cancer: the Japanese experience. Int J Clin Oncol 2004;9:352–355.

    Article  PubMed  Google Scholar 

  30. 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;24:4833–4839.

    Article  PubMed  Google Scholar 

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© 2007 Springer-Verlag Berlin Heidelberg

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McGarry, R.C. (2007). Stereotactic Body Radiation Therapy in the Treatment of Early Stage Non-Small Cell Lung Cancer. In: Urschel, H.C., Kresl, J.J., Luketich, J.D., Papiez, L., Timmerman, R.D., Schulz, R.A. (eds) Treating Tumors that Move with Respiration. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-69886-9_13

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  • DOI: https://doi.org/10.1007/978-3-540-69886-9_13

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-69885-2

  • Online ISBN: 978-3-540-69886-9

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