A Prospective Study Of Stereotactic Body Radiation Therapy In Stage â… /â…¡ Non-small-cell Lung Cancer

Purpose:To further evaluate the2years local control rate, survival rate and toxicity of the stereotactic gamma-ray body radiation therapy (y-SBRT) for patients with stage I/II non-small cell lung cancer (NSCLC) basing the preliminary studies.Methods:29eligible patients with stage Ⅰ/Ⅱ NSCLC who is unable or unwilling to do surgery underwent treatment prospectively using y-SBRT (OUR-QGD). The patients were fixed by a vacuum bag. Each patient underwent slow CT simulation at5s/slide with a CT-slide thickness of5mm and CT-slide interval of5mm to take into consideration tumor motion. A total dose of50Gy was delivered at5Gy/fraction to50%isodose line covering100%of the PTV, a total dose of60Gy was delivered at6Gy/fraction to60%isodose line covering90%of the CTV, and a total dose of70Gy was delivered at7Gy/fraction to70%isodose line covering80%of the GTV,10times finished by2weeks in5fractions per week. The follow-up interval was3for the first year and every6months thereafter for all of the patients. CT scans of the chest were required to evaluate the efficacy.Results:The median follow-up duration was24months.1case was lost in8-month making the final follow-up rate to96.55%. The1-,3-,6-month local tumor response rates were79.31%,89.65%and93.10%respectively, with CR17.24%,44.83%,86.21%, and PR62.07%,44.82%,6.90%. The1-,2-year local control rates were all93.1%. The1-,2-year overall survival rates were96.6%and89.4%, in those with Stage Ⅰ disease were100%,92.0%, Stage Ⅱ were66.7%,66.7%, respectively. The1-,2-year progression-free survival were89.7%and86.1%, respectively.34.48%of the patients had acute radiation reactions (Ⅰ in20.69%, Ⅱ in6.90%, Ⅲ in6.90%) within3months after treatment, and37.93%of the patients had late radiation reactions (Ⅰ in34.48%, Ⅱ in3.45%).Conclusion:The evidence showed that γ-SBRT resulted in promising local control and survival with minimal toxicity, which is safe and effective treatment.