Universität zu Köln

Temming, Susanne, Kocher, Martin, Stoelben, Erich, Hagmeyer, Lars, Chang, De-Hua, Frank, Konrad, Hekmat, Khosro, Wolf, Juergen, Baus, Wolfgang W., Semrau, Robert, Baues, Christian and Marnitz, S. (2018). Risk-adapted robotic stereotactic body radiation therapy for inoperable early-stage non-small-cell lung cancer. Strahlenther. Onkol., 194 (2). S. 91 - 98. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1439-099X

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Abstract

To evaluate efficacy and toxicity of stereotactic body radiation therapy (SBRT) with CyberKnifeA (R) (Accuray, Sunnyvale, CA, USA) in a selected cohort of primary, medically inoperable early-stage non-small cell lung cancer (NSCLC) patients. From 2012 to 2016, 106 patients (median age 74 years, range 50-94 years) with primary NSCLC were treated with SBRT using CyberKnifeA (R). Histologic confirmation was available in 87 patients (82%). For mediastinal staging, 92 patients (87%) underwent F-18-fluorodeoxyglucose positron-emission tomography (18-FDG-PET) and/or endobronchial ultrasound (EBUS)-guided lymph node biopsy or mediastinoscopy. Tumor stage (UICC8, 2017) was IA/B (T1a-c, 1-3 cm) in 86 patients (81%) and IIA (T2a/b, 3-5 cm) in 20 patients (19%). Depending on tumor localization, three different fractionation schedules were used: 3 fractions of 17Gy, 5 fractions of 11Gy, or 8 fractions of 7.5 Gy. Tracking was based on fiducial implants in 13 patients (12%) and on image guidance without markers in 88%. Median follow-up was 15 months (range 0.5-46 months). Acute side effects were mild (fatigue grade 1-2 in 20% and dyspnea grade 1-2 in 17%). Late effects were observed in 4 patients (4%): 3 patients developed pneumonitis requiring therapy (grade 2) and 1 patient suffered a rib fracture (grade 3). In total, 9/106 patients (8%) experienced a local recurrence, actuarial local control rates were 88% (95% confidence interval, CI, 80-96%) at 2 years and 77% (95%CI 56-98%) at 3 years. The median disease-free survival time was 27 months (95%CI 23-31 months). Overall survival was 77% (95%CI 65-85%) at 2 years and 56% (95%CI 39-73%) at 3 years. CyberKnifeA (R) lung SBRT which allows for real-time tumor tracking and risk-adapted fractionation achieves satisfactory local control and low toxicity rates in inoperable early-stage primary lung cancer patients.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Temming, Susanne UNSPECIFIED UNSPECIFIED UNSPECIFIED Kocher, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Stoelben, Erich UNSPECIFIED UNSPECIFIED UNSPECIFIED Hagmeyer, Lars UNSPECIFIED UNSPECIFIED UNSPECIFIED Chang, De-Hua UNSPECIFIED UNSPECIFIED UNSPECIFIED Frank, Konrad UNSPECIFIED UNSPECIFIED UNSPECIFIED Hekmat, Khosro UNSPECIFIED UNSPECIFIED UNSPECIFIED Wolf, Juergen UNSPECIFIED UNSPECIFIED UNSPECIFIED Baus, Wolfgang W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Semrau, Robert UNSPECIFIED UNSPECIFIED UNSPECIFIED Baues, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Marnitz, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-196739
DOI:	10.1007/s00066-017-1194-x
Journal or Publication Title:	Strahlenther. Onkol.
Volume:	194
Number:	2
Page Range:	S. 91 - 98
Date:	2018
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1439-099X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language POSITRON-EMISSION-TOMOGRAPHY; TUMOR-CONTROL PROBABILITY; ABLATIVE RADIOTHERAPY; ELDERLY-PATIENTS; I NSCLC; OUTCOMES; TRACKING; SBRT; CT Multiple languages Oncology; Radiology, Nuclear Medicine & Medical Imaging Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/19673