Stereotactic body radiation therapy for nonmetastatic lung cancer: An analysis of 75 patients treated over 5 years

Purpose: Non–small-cell lung cancer (NSCLC) may not be medically operable even in patients with surgically resectable disease. For patients who either refuse surgery or are medically inoperable, radiation therapy may be the best therapeutic choice. Stereotactic body radiation therapy (SBRT) employs external fixation and hypofractionation to deliver a high dose per fraction of radiation to a small target volume.

Methods and Materials: Retrospective review of 75 patients treated over 5 years at Staten Island University Hospital as definitive treatment for NSCLC or presumed NSCLC. Patients received a median of 5 fractions of 8 Gy per fraction over 27 days.

Results: Overall 1-, 2-, and 5-year actuarial survivals were 63%, 45%, and 17%. Patients with a gross tumor volume (GTV) less than 65 cm³ enjoyed a longer median survival (25.7 vs. 9.9 months, p < 0.003), and at 5 years, the actuarial survival for the patients with GTVs less than 65 cm³ was 24% vs. 0% for those with GTVs larger than 65 cm³.

Conclusions: Stereotactic body radiation therapy as delivered was ineffective for curing the patients whose GTVs were larger than 65 cm³. SBRT was promising for those with GTVs less than 65 cm³.

Keywords:  Non–small-cell lung cancer , Lung cancer , Stereotactic body radiation therapy , Body radiosurgery , Extracranial radiosurgery