PMID- 33777572
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210330
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 13
IP  - 2
DP  - 2021 Feb 22
TI  - Early-Stage Non-Small Cell Lung Cancer Stereotactic Body Radiation Therapy (SBRT) 
      Outcomes in an Equal Access Military Setting.
PG  - e13485
LID - 10.7759/cureus.13485 [doi]
LID - e13485
AB  - Introduction Lung stereotactic body radiation therapy (SBRT) is a first-line 
      treatment for early-stage lung cancer in non-surgical candidates or those who 
      refuse surgery. We compared our institutional outcomes from a unique patient 
      population with decreased barriers to care with a recently published prospective 
      series. Materials and methods  We retrospectively reviewed all patients who 
      received definitive lung SBRT at the Walter Reed National Military Medical Center 
      from 2015 to 2020. All patients underwent a positron emission tomography-computed 
      tomography (PET-CT) and all were presented at a multidisciplinary tumor board. 
      Patients were treated on a Trubeam linear accelerator (LINAC)-based system with 
      daily cone-beam CT. The results were qualitatively compared to outcomes from 
      prospective studies including RTOG 0236 and RTOG 0618. Results A total of 105 
      patients with 114 lesions were included. Median age was 77 years and 54.7% had >/= 
      40-pack year smoking history. 36.8% did not have pathologic confirmation. With a 
      median follow-up of 24 months, three-year local control (LC), disease-free 
      survival (DFS) and overall survival (OS) rates were 92.4%, 81.0%, and 80.0%, 
      respectively. Rates of Grade 1 and 2 toxicity were 21.9% and 6.7% and no patients 
      experienced Grade >/= 3 toxicity. Conclusions In our military setting with 
      universal coverage and routine multidisciplinary care, lung SBRT provides 
      outcomes comparable to prospective studies conducted at high-volume academic 
      centers. More than one-third of patients were treated empirically without 
      pathologic confirmation of disease, demonstrating a difference between clinical 
      trials and community practice. Further investigation is warranted to integrate 
      multidisciplinary management and achieve equal access to care to bridge existing 
      health disparities in the community setting.
CI  - Copyright (c) 2021, Chaurasia et al.
FAU - Chaurasia, Avinash R
AU  - Chaurasia AR
AD  - Radiation Oncology, National Capital Consortium, Bethesda, USA.
FAU - White, John
AU  - White J
AD  - Radiation Oncology Residency, National Capital Consortium, Bethesda, USA.
FAU - Beckmann, Robert C
AU  - Beckmann RC
AD  - Radiation Oncology, National Capital Consortium, Bethesda, USA.
FAU - Chamberlin, Michael
AU  - Chamberlin M
AD  - Radiation Oncology, Tripler Army Medical Center, Honolulu, USA.
FAU - Horn, Adam
AU  - Horn A
AD  - Radiation Oncology, Naval Medical Center, San Diego, USA.
FAU - Torgeson, Anna M
AU  - Torgeson AM
AD  - Radiation Oncology, National Capital Consortium, Bethesda, USA.
FAU - Skinner, William
AU  - Skinner W
AD  - Radiation Oncology, Chesapeake Urology, Gaithersburg, USA.
FAU - Erickson, Delnora
AU  - Erickson D
AD  - Radiation Oncology, National Capital Consortium, Bethesda, USA.
FAU - Reed, Aaron
AU  - Reed A
AD  - Radiation Oncology, National Capital Consortium, Bethesda, USA.
LA  - eng
PT  - Journal Article
DEP - 20210222
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC7990000
OTO - NOTNLM
OT  - community
OT  - equal access
OT  - lung cancer
OT  - military
OT  - non-small cell lung cancer
OT  - radiation therapy
OT  - stereotactic ablative body radiotherapy
OT  - stereotactic body radiation therapy
COIS- The authors have declared that no competing interests exist.
EDAT- 2021/03/30 06:00
MHDA- 2021/03/30 06:01
PMCR- 2021/02/22
CRDT- 2021/03/29 06:32
PHST- 2021/03/29 06:32 [entrez]
PHST- 2021/03/30 06:00 [pubmed]
PHST- 2021/03/30 06:01 [medline]
PHST- 2021/02/22 00:00 [pmc-release]
AID - 10.7759/cureus.13485 [doi]
PST - epublish
SO  - Cureus. 2021 Feb 22;13(2):e13485. doi: 10.7759/cureus.13485.