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Dynamic Lung Tumor Tracking for Stereotactic Ablative Body Radiation Therapy
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Stage I Lung SBRT Clinical Practice Patterns.

Christopher D Corso1, Henry S Park, Amy C Moreno

  • 1Departments of *Therapeutic Radiology ‡Thoracic Surgery, Yale School of Medicine †Yale Cancer Center, New Haven, CT.

American Journal of Clinical Oncology
|December 16, 2014
PubMed
Summary
This summary is machine-generated.

Stereotactic body radiation therapy (SBRT) for inoperable stage I non-small cell lung cancer (NSCLC) shows increasing use, with most patients receiving biologically effective doses (BED10) of at least 100 Gy. Prescription patterns are shifting from 3-fraction high-dose regimens to 5-fraction lower-dose schedules.

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Area of Science:

  • Oncology
  • Radiation Oncology
  • Medical Physics

Background:

  • Stereotactic body radiation therapy (SBRT) is increasingly used for inoperable stage I non-small cell lung cancer (NSCLC).
  • Standardized dosing guidelines for SBRT in NSCLC are lacking.
  • This study examines SBRT dose prescription patterns in the United States.

Purpose of the Study:

  • To investigate dose prescription patterns for SBRT in stage I NSCLC patients in the US.
  • To analyze trends in SBRT utilization and dose selection over time.
  • To understand the evolution of SBRT dosing in clinical practice.

Main Methods:

  • Retrospective analysis of 5246 patients with stage I NSCLC treated with SBRT.
  • Data sourced from the National Cancer Database (NCDB) between 2004 and 2011.
  • Analysis of SBRT use trends and dose prescription patterns, including biologically effective dose (BED10).

Main Results:

  • The majority of patients (94.5%) received a BED10 ≥ 100 Gy.
  • Common prescriptions included 60 Gy in 3 fractions (24.1%) and 48 Gy in 4 fractions (17.8%).
  • Significant shifts observed: decreased use of 54-60 Gy in 3 fractions (47.9% to 27.9%) and increased use of 50 Gy in 5 fractions (3.1% to 20.4%) from 2006 to 2011.

Conclusions:

  • SBRT use for stage I NSCLC has increased, with most patients receiving BED10 ≥ 100 Gy.
  • A trend towards lower-dose, higher-fraction regimens (e.g., 50 Gy in 5 fractions) is evident.
  • Shifting patterns may reflect concerns about toxicity and treatment of centrally located tumors.