Stereotactic body radiation therapy favors long-term overall survival in patients with lung metastases: five-year experience of a single-institution / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Metastatic lung cancer is one of the most common oncologic problems. This study aimed to evaluate the long-term clinical outcome of stereotactic body radiation therapy (SBRT) for metastatic lung tumors.</p><p><b>METHODS</b>We retrospectively reviewed the 71 patients with lung metastases, who had 172 lesions treated with SBRT from January 2000 to December 2006. All patients were unfit or failed after surgery and/or chemotherapy. The median total dose was 48 Gy (range, 30 - 60) in 4 (range, 2 - 12) fractions. The median size of the irradiated lesions was 2.1 cm (range, 0.9 - 7.9 cm).</p><p><b>RESULTS</b>All but two patients received follow up. The median follow-up time was 24.7 months (range, 2.9 - 114.4 months). The median follow-up time for living patients was 86.8 months (range, 58.1 - 114.4 months). The 1-, 3-, 5-year local control and overall survival rates were 88.8%, 75.4%, 75.4% and 78.9%, 40.8%, 25.2%. Multivariate analysis showed that the absence of extrapulmonary metastases (P = 0.024; hazard ratio (HR), 1.894; 95% confidence interval (CI), 1.086 - 3.303) and disease-free interval ≤ 12 months (P = 0.014; HR, 0.511; 95%CI, 0.299 - 0.873) were independent prognostic factors. No grade 3 or more acute and late toxicities occurred. Only one patient developed a non-symptomatic rib fracture.</p><p><b>CONCLUSION</b>SBRT could be an alternative treatment to surgery for subsets of patients with lung metastases with favorable long-term survival and tolerable complications.</p>

Preliminary results of postoperative three-dimensional conformal radiotherapy versus conventional radiotherapy in stageⅢA non-small cell lung cancer / 中华放射肿瘤学杂志

Objective To evaluate the preliminary outcome of postoperative three-dimensional conformal radiation therapy(3DCRT)as compared with conventional radiation therapy(CRT)in stageⅢA non-small cell lung cancer(NSCLC).Methods From December 1994 to February 2002,114 such patients received postoperative radiotherapy in M.D.Anderson Cancer Center,with 63 patients in CRT group and 51 in 3DCRT group.The median radiation dose was 53.5 Gy/27f/5-6w and 52.8 Gy/26f/5-6w in CRT and 3DCRT group, respectively.Results The median follow-up time was 28 and 13 months in CRT and 3DCRT group.The 1-,2- year overaLl survival were 80%,62% and 93%,70%.The 1-,2-year disease free survival was 62%,44% and 58%,32% in CRT group and in 3DCRT group,respectively.There was no significant difference between CRT group and 3DCRT group in terms of overall survival,disease-free survival,local-regional control,distant metastasis-free survival or treatment-related complication.There was significant difference in the death cause between two group,with 4 patients having died of cardiac complication in the CRT group and none in the 3DCRT group.Conclusions Postoperative three-dimensional conformal radiotherapy can reach the same immediate results of conventional radiotherapy in stageⅢA NSCLC,with a lower incidence of cardiac complication. However,the long-term results need further follow-up.