PMID- 24813936
OWN - NLM
STAT- MEDLINE
DCOM- 20150120
LR  - 20220716
IS  - 1872-8332 (Electronic)
IS  - 0169-5002 (Print)
IS  - 0169-5002 (Linking)
VI  - 85
IP  - 1
DP  - 2014 Jul
TI  - Comparison of accelerated hypofractionation and stereotactic body radiotherapy 
      for Stage 1 and node negative Stage 2 non-small cell lung cancer (NSCLC).
PG  - 59-65
LID - S0169-5002(14)00170-6 [pii]
LID - 10.1016/j.lungcan.2014.04.003 [doi]
AB  - PURPOSE: Stereotactic body radiation therapy (SBRT) and accelerated 
      hypofractionated radiation therapy (AHRT) have favorable local control (LC) 
      relative to conventional fractionation in the treatment of stage I non-small cell 
      lung cancer (NSCLC). We report the results of our single institution experience 
      with the treatment of early stage NSCLC with SBRT or AHRT in cases where SBRT was 
      felt to be suboptimal. METHODS: One hundred and sixty patients with Stage 1 and 
      node negative Stage 2 NSCLC were treated with SBRT or AHRT from 2003 to 2011. 
      Median follow-up was 29.4 and 19 months (mo), respectively. The median dose was 
      54Gy in 3 fractions (fx) (SBRT) and 70.2Gy in 26 fx (AHRT). Acute and late 
      toxicities (tox) were graded (G) per CTCAE v4. Time to local (LF), regional (RF) 
      and distant (DF) failure were estimated using the Kaplan-Meier method. The impact 
      of patient and tumor related factors on LF were estimated by multivariate Cox 
      proportional hazard model. RESULTS: Three-year LC rates were 87.7% (SBRT) and 
      71.7% (AHRT). The 3-year freedom from DF was 73.3% and 68.1%. Median OS was 38.4 
      (95% CI 29.7-51.6) and 35 (95% CI 22-48.3) mo. No G3 or 4 tox were observed. At 1 
      year, 30% and 50% of complications resolved, while (5-6%) had persistent chest 
      wall pain. Multivariate analysis demonstrated that increasing dose per fraction 
      and tumor size (>5.5 vs. 4cm) in the AHRT and SBRT group were found to be 
      associated with a reduced (HR 0.33 95% CI 0.13-0.84, p=0.021) and increased (HR: 
      6.372 95% CI 1.23-32.92, p=0.027) hazard for local failure respectively. 
      CONCLUSIONS: Our results compare favorably with other reports of treatment for 
      early stage NSCLC. AHRT patients had comparable LC despite increased size and 
      central disease. Toxicity was limited and overall survival, regional and distant 
      recurrences were similar between groups.
CI  - Published by Elsevier Ireland Ltd.
FAU - Lucas, John T Jr
AU  - Lucas JT Jr
AD  - Department of Radiation Oncology, Wake Forest Baptist Medical Center, Winston 
      Salem, NC, United States. Electronic address: johnthomas75@gmail.com.
FAU - Kuremsky, Jeffrey G
AU  - Kuremsky JG
AD  - Department of Radiation Oncology, Wake Forest Baptist Medical Center, Winston 
      Salem, NC, United States.
FAU - Soike, Mike
AU  - Soike M
AD  - Department of Radiation Oncology, Wake Forest Baptist Medical Center, Winston 
      Salem, NC, United States.
FAU - Hinson, William W
AU  - Hinson WW
AD  - Department of Radiation Oncology, Wake Forest Baptist Medical Center, Winston 
      Salem, NC, United States.
FAU - Kearns, William T
AU  - Kearns WT
AD  - Department of Radiation Oncology, Wake Forest Baptist Medical Center, Winston 
      Salem, NC, United States.
FAU - Hampton, Carnell J
AU  - Hampton CJ
AD  - Southeastern Radiation Oncology Physics Group, Wake Forest Baptist Medical 
      Center, Winston Salem, NC, United States.
FAU - Blackstock, A William
AU  - Blackstock AW
AD  - Department of Radiation Oncology, Wake Forest Baptist Medical Center, Winston 
      Salem, NC, United States.
FAU - Urbanic, James
AU  - Urbanic J
AD  - Department of Radiation Oncology, Wake Forest Baptist Medical Center, Winston 
      Salem, NC, United States.
LA  - eng
GR  - P30 CA012197/CA/NCI NIH HHS/United States
PT  - Comparative Study
PT  - Journal Article
DEP - 20140428
PL  - Ireland
TA  - Lung Cancer
JT  - Lung cancer (Amsterdam, Netherlands)
JID - 8800805
SB  - IM
MH  - Aged
MH  - Carcinoma, Non-Small-Cell Lung/mortality/pathology/*radiotherapy
MH  - Dose Fractionation, Radiation
MH  - Female
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Lung Neoplasms/mortality/pathology/*radiotherapy
MH  - Male
MH  - Neoplasm Staging
MH  - Proportional Hazards Models
MH  - Radiosurgery
MH  - Retrospective Studies
MH  - Treatment Outcome
PMC - PMC9137043
MID - NIHMS1807720
OTO - NOTNLM
OT  - Accelerated hypofractionated radiotherapy
OT  - Involved-field radiotherapy
OT  - Lung cancer
OT  - Non-small cell lung cancer
OT  - Radiation
OT  - Stereotactic body radiation therapy
COIS- Conflict of Interests Statement I do not have neither competing interests, 
      relationships, intellectual property/patents pertaining to the current work, 
      conditions, other relevant financial activities, circumstances, nor funding to 
      disclose.
EDAT- 2014/05/13 06:00
MHDA- 2015/01/21 06:00
PMCR- 2022/05/27
CRDT- 2014/05/13 06:00
PHST- 2013/11/01 00:00 [received]
PHST- 2014/02/25 00:00 [revised]
PHST- 2014/04/06 00:00 [accepted]
PHST- 2014/05/13 06:00 [entrez]
PHST- 2014/05/13 06:00 [pubmed]
PHST- 2015/01/21 06:00 [medline]
PHST- 2022/05/27 00:00 [pmc-release]
AID - S0169-5002(14)00170-6 [pii]
AID - 10.1016/j.lungcan.2014.04.003 [doi]
PST - ppublish
SO  - Lung Cancer. 2014 Jul;85(1):59-65. doi: 10.1016/j.lungcan.2014.04.003. Epub 2014 
      Apr 28.