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  • Title: Stereotactic radiotherapy of histologically proven inoperable stage I non-small cell lung cancer: patterns of failure.
    Author: Andratschke N, Zimmermann F, Boehm E, Schill S, Schoenknecht C, Thamm R, Molls M, Nieder C, Geinitz H.
    Journal: Radiother Oncol; 2011 Nov; 101(2):245-9. PubMed ID: 21724287.
    Abstract:
    BACKGROUND AND PURPOSE: To report patterns of failure of stereotactic body radiation therapy (SBRT) in inoperable patients with histologically confirmed stage I NSCLC. MATERIALS AND METHODS: Ninety-two inoperable patients (median age: 75 years) with clinically staged, histologically proven T1 (n=31) or T2 (n=61), N0, M0 non-small cell lung cancer (NSCLC) were included in this study. Treatment consisted of 3-5 fractions with 7-15 Gy per fraction prescribed to the 60% isodose. RESULTS: Freedom from local recurrence at 1, 3 and 5 years was 89%, 83% and 83%, respectively. All 10 local failures were observed in patients with T2 tumors. Isolated regional recurrence was observed in 7.6%. The crude rate of distant progression was 20.7%. Overall survival at 1, 3, and 5 years was 79%, 38% and 17% with a median survival of 29 months. Disease specific survival at 1, 3, and 5 years was 93%, 64% and 48%. Karnofsky performance status, T stage, gross tumor volume and tumor location had no significant impact on overall and disease specific survival. SBRT was generally well tolerated and all patients completed therapy as planned. CONCLUSION: SBRT for stage I lung cancer is very well tolerated in this patient cohort with significant cardiopulmonal comorbidity and results in excellent local control rates, although a considerable portion develops regional and distant metastases.
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