Fractionated stereotactic body radiation therapy in the treatment of primary, recurrent, and metastatic lung tumors: The role of positron emission tomography/computed tomography - based treatment planning

Devin O'Brien-Coon, Abhay S. Gokhale, Steven A. Burton, Dwight E. Heron, Cihat Ozhasoglu, Neil Christie

Research output: Contribution to journalArticle

Abstract

Purpose: The aim of this study was to assess the outcomes of patients treated with stereotactic body radiation therapy (SBRT) in patients with primary, recurrent, or metastatic lung lesions, with a focus on positron emission tomography (PET)/computed tomography (CT) - based management. Patients and Methods: Fifty-one patients with primary stage I non - small-cell lung cancer (NSCLC; n = 26), recurrent lung cancer after definitive treatment (n = 12), or solitary lung metastases (n = 13) were treated with SBRT between 2005 and 2007. Patients were treated with the CyberKnife® Robotic Radiosurgery System with Synchrony™ respiratory tracking. A dose of 60 Gy was delivered in 3 fractions. All patients had CT or PET/CT performed at approximately 3-month intervals after treatment. Results: The median follow-up was 12 months. Local control at median follow-up was 85% in patients with stage I NSCLC, 92% in patients with recurrent lung cancer, and 62% in the patients with solitary lung metastasis. Analysis of the 28 patients with pre- and post-treatment PET/CT scans demonstrated that those with stable disease (n = 4) had a mean standardized uptake value (SUV) decrease of 28%, partial responders (n = 11) had a decrease of 48%, and patients with a complete response (n = 11) had a decrease of 94%. Patients with progressive disease (n = 2) had an SUV decrease of only 0.4%. Only 2 patients (7%) who had reduced fluorodeoxyglucose avidity later progressed locally. No correlations were found between pretreatment SUV and tumor response, disease progression, or survival. Overall 1-year survival rates were 81%, 67%, and 85% among the patients with primary NSCLC, recurrent lung cancer, and solitary lung metastases, respectively. Conclusion: Stereotactic body radiation therapy with CyberKnife® is an effective treatment for patients with medically inoperable recurrent or metastatic lung cancer. Positron emission tomography/CT is valuable in staging, planning, and evaluating treatment response and might predict long-term outcome.

Original languageEnglish (US)
Pages (from-to)217-221
Number of pages5
JournalClinical Lung Cancer
Volume9
Issue number4
DOIs
StatePublished - Jan 1 2008
Externally publishedYes

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Radiotherapy
Lung
Neoplasms
Lung Neoplasms
Therapeutics
Positron Emission Tomography Computed Tomography
Neoplasm Metastasis
Radiosurgery
Robotics
Non-Small Cell Lung Carcinoma
Disease Progression
Survival Rate
Tomography

Keywords

  • Cyberknife
  • Hypofractionated
  • Standardized uptake value
  • Synchrony

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine
  • Cancer Research

Cite this

Fractionated stereotactic body radiation therapy in the treatment of primary, recurrent, and metastatic lung tumors : The role of positron emission tomography/computed tomography - based treatment planning. / O'Brien-Coon, Devin; Gokhale, Abhay S.; Burton, Steven A.; Heron, Dwight E.; Ozhasoglu, Cihat; Christie, Neil.

In: Clinical Lung Cancer, Vol. 9, No. 4, 01.01.2008, p. 217-221.

Research output: Contribution to journalArticle

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abstract = "Purpose: The aim of this study was to assess the outcomes of patients treated with stereotactic body radiation therapy (SBRT) in patients with primary, recurrent, or metastatic lung lesions, with a focus on positron emission tomography (PET)/computed tomography (CT) - based management. Patients and Methods: Fifty-one patients with primary stage I non - small-cell lung cancer (NSCLC; n = 26), recurrent lung cancer after definitive treatment (n = 12), or solitary lung metastases (n = 13) were treated with SBRT between 2005 and 2007. Patients were treated with the CyberKnife{\circledR} Robotic Radiosurgery System with Synchrony™ respiratory tracking. A dose of 60 Gy was delivered in 3 fractions. All patients had CT or PET/CT performed at approximately 3-month intervals after treatment. Results: The median follow-up was 12 months. Local control at median follow-up was 85{\%} in patients with stage I NSCLC, 92{\%} in patients with recurrent lung cancer, and 62{\%} in the patients with solitary lung metastasis. Analysis of the 28 patients with pre- and post-treatment PET/CT scans demonstrated that those with stable disease (n = 4) had a mean standardized uptake value (SUV) decrease of 28{\%}, partial responders (n = 11) had a decrease of 48{\%}, and patients with a complete response (n = 11) had a decrease of 94{\%}. Patients with progressive disease (n = 2) had an SUV decrease of only 0.4{\%}. Only 2 patients (7{\%}) who had reduced fluorodeoxyglucose avidity later progressed locally. No correlations were found between pretreatment SUV and tumor response, disease progression, or survival. Overall 1-year survival rates were 81{\%}, 67{\%}, and 85{\%} among the patients with primary NSCLC, recurrent lung cancer, and solitary lung metastases, respectively. Conclusion: Stereotactic body radiation therapy with CyberKnife{\circledR} is an effective treatment for patients with medically inoperable recurrent or metastatic lung cancer. Positron emission tomography/CT is valuable in staging, planning, and evaluating treatment response and might predict long-term outcome.",
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