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Published on: May 8, 2018
Outcomes of stereotactic ablative radiotherapy for central lung tumours: a systematic review
Sashendra Senthi1, Cornelis J A Haasbeek, Ben J Slotman
1Department of Radiation Oncology, VU University Medical Center, Amsterdam, The Netherlands. s.senthi@vumc.nl
Background And Purpose:
Stereotactic ablative radiotherapy (SABR) has improved the survival for medically inoperable patients with peripheral early-stage non-small cell lung cancer (NSCLC). We performed a systematic review of outcomes for central lung tumours.
Material And Methods:
The systematic review was performed following PRISMA guidelines. Survival outcomes were evaluated for central early-stage NSCLC. Local control and toxicity outcomes were evaluated for any centrally-located lung tumour.
Results:
Twenty publications met the inclusion criteria, reporting outcomes for 563 central lung tumours, including 315 patients with early-stage NSCLC. There was heterogeneity in the planning, prescribing and delivery of SABR and the common toxicity criteria used to define toxicities (versions 2.0-4.0). Tumour location (central versus peripheral) did not impact overall survival. Local control rates were ≥ 85% when the prescribed biologically equivalent tumour dose was ≥ 100 Gy. Treatment-related mortality was 2.7% overall, and 1.0% when the biologically equivalent normal tissue dose was ≤ 210 Gy. Grade 3 or 4 toxicities may be more common following SABR for central tumours, but occurred in less than 9% of patients.
Conclusions:
Post-SABR survival for early-stage NSCLC is not affected by tumour location. SABR achieves high local control with limited toxicity when appropriate fractionation schedules are used for central tumours.
