PMID- 29873277
OWN - NLM
STAT- MEDLINE
DCOM- 20190305
LR  - 20200225
IS  - 1651-226X (Electronic)
IS  - 0284-186X (Print)
IS  - 0284-186X (Linking)
VI  - 57
IP  - 11
DP  - 2018 Nov
TI  - Stereotactic body radiation therapy (SBRT) improves local control and overall 
      survival compared to conventionally fractionated radiation for stage I non-small 
      cell lung cancer (NSCLC).
PG  - 1567-1573
LID - 10.1080/0284186X.2018.1481292 [doi]
AB  - BACKGROUND: Stereotactic body radiotherapy (SBRT) has been adopted as the 
      standard of care for inoperable early-stage non-small cell lung cancer (NSCLC), 
      with local control rates consistently >90%. However, data directly comparing the 
      outcomes of SBRT with those of conventionally fractionated radiotherapy (CONV) is 
      lacking. MATERIAL AND METHODS: Between 1990 and 2013, 497 patients (525 lesions) 
      with early-stage NSCLC (T1-T2N0M0) were treated with CONV (n = 127) or SBRT 
      (n = 398). In this retrospective analysis, five endpoints were compared, with and 
      without adjusting for clinical and dosimetric factors. Competing risks analysis 
      was performed to estimate and compare the cumulative incidence of local failure 
      (LF), nodal failure (NF), distant failure (DF) and disease progression. Overall 
      survival (OS) was estimated by the Kaplan-Meier method and compared by the Cox 
      regression model. Propensity score (PS) matched analysis was performed based on 
      seven patient and clinical variables: age, gender, Karnofsky performance status 
      (KPS), histology, T stage, biologically equivalent dose (BED), and history of 
      smoking. RESULTS: The median dose delivered for CONV was 75.6 Gy in 1.8-2.0 Gy 
      fractions (range 60-90 Gy; median BED = 89.20 Gy) and for SBRT 48 Gy in four 
      fractions (45-60 Gy in three to five fractions; median BED = 105.60 Gy). Median 
      follow-up was 24.4 months, and 3-year LF rates were 34.1% with CONV and 13.6% 
      with SBRT (p < .001). Three-year OS rates were 38.9 and 53.1%, respectively 
      (p = .018). PS matching showed a significant improvement of OS (p = .0497) for 
      SBRT. T stage was the only variable correlating with all five endpoints. 
      CONCLUSION: SBRT compared to CONV is associated with improved LF rates and OS. 
      Our data supports the continued use and expansion of SBRT as the standard of care 
      treatment for inoperable early-stage NSCLC.
FAU - von Reibnitz, Donata
AU  - von Reibnitz D
AD  - a Department of Radiation Oncology , Memorial Sloan Kettering Cancer Center , New 
      York , New York , USA.
FAU - Shaikh, Fauzia
AU  - Shaikh F
AD  - a Department of Radiation Oncology , Memorial Sloan Kettering Cancer Center , New 
      York , New York , USA.
FAU - Wu, Abraham J
AU  - Wu AJ
AD  - a Department of Radiation Oncology , Memorial Sloan Kettering Cancer Center , New 
      York , New York , USA.
FAU - Treharne, Gregory C
AU  - Treharne GC
AD  - a Department of Radiation Oncology , Memorial Sloan Kettering Cancer Center , New 
      York , New York , USA.
FAU - Dick-Godfrey, Rosalind
AU  - Dick-Godfrey R
AD  - a Department of Radiation Oncology , Memorial Sloan Kettering Cancer Center , New 
      York , New York , USA.
FAU - Foster, Amanda
AU  - Foster A
AD  - a Department of Radiation Oncology , Memorial Sloan Kettering Cancer Center , New 
      York , New York , USA.
FAU - Woo, Kaitlin M
AU  - Woo KM
AD  - b Department of Epidemiology and Biostatistics , Memorial Sloan Kettering Cancer 
      Center , New York , New York , USA.
FAU - Shi, Weiji
AU  - Shi W
AD  - b Department of Epidemiology and Biostatistics , Memorial Sloan Kettering Cancer 
      Center , New York , New York , USA.
FAU - Zhang, Zhigang
AU  - Zhang Z
AD  - b Department of Epidemiology and Biostatistics , Memorial Sloan Kettering Cancer 
      Center , New York , New York , USA.
FAU - Din, Shaun U
AU  - Din SU
AD  - a Department of Radiation Oncology , Memorial Sloan Kettering Cancer Center , New 
      York , New York , USA.
FAU - Gelblum, Daphna Y
AU  - Gelblum DY
AD  - a Department of Radiation Oncology , Memorial Sloan Kettering Cancer Center , New 
      York , New York , USA.
FAU - Yorke, Ellen D
AU  - Yorke ED
AD  - c Department of Medical Physics , Memorial Sloan Kettering Cancer Center , New 
      York , New York , USA.
FAU - Rosenzweig, Kenneth E
AU  - Rosenzweig KE
AD  - d Department of Radiation Oncology , Mount Sinai Medical Center , New York , New 
      York , USA.
FAU - Rimner, Andreas
AU  - Rimner A
AD  - a Department of Radiation Oncology , Memorial Sloan Kettering Cancer Center , New 
      York , New York , USA.
LA  - eng
GR  - P30 CA008748/CA/NCI NIH HHS/United States
PT  - Comparative Study
PT  - Journal Article
DEP - 20180606
PL  - Sweden
TA  - Acta Oncol
JT  - Acta oncologica (Stockholm, Sweden)
JID - 8709065
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Carcinoma, Non-Small-Cell Lung/mortality/pathology/*radiotherapy
MH  - *Dose Fractionation, Radiation
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Lung Neoplasms/mortality/pathology/*radiotherapy
MH  - Middle Aged
MH  - Neoplasm Recurrence, Local
MH  - Radiosurgery/*methods
MH  - Retrospective Studies
MH  - Treatment Failure
MH  - Treatment Outcome
PMC - PMC6508090
MID - NIHMS1515669
COIS- Conflict of interest: None
EDAT- 2018/06/07 06:00
MHDA- 2019/03/06 06:00
PMCR- 2019/11/01
CRDT- 2018/06/07 06:00
PHST- 2018/06/07 06:00 [pubmed]
PHST- 2019/03/06 06:00 [medline]
PHST- 2018/06/07 06:00 [entrez]
PHST- 2019/11/01 00:00 [pmc-release]
AID - 10.1080/0284186X.2018.1481292 [doi]
PST - ppublish
SO  - Acta Oncol. 2018 Nov;57(11):1567-1573. doi: 10.1080/0284186X.2018.1481292. Epub 
      2018 Jun 6.