Influence of Fractionation Scheme and Tumor Location on Toxicities After Stereotactic Body Radiation Therapy for Large (>/=5 cm) Non-Small Cell Lung Cancer: A Multi-institutional Analysis Journal Article

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Authors: Verma, V.; Shostrom, V. K.; Zhen, W.; Zhang, M; Braunstein, S. E.; Holland, J.; Hallemeier, C. L.; Harkenrider, M. M.; Iskhanian, A.; Jabbour, S. K.; Attia, A.; Lee, P; Wang, K; Decker, R. H.; McGarry, R. C.; Simone, C. B., 2nd
Article Title: Influence of Fractionation Scheme and Tumor Location on Toxicities After Stereotactic Body Radiation Therapy for Large (>/=5 cm) Non-Small Cell Lung Cancer: A Multi-institutional Analysis
Abstract: PURPOSE: To describe the impact of fractionation scheme and tumor location on toxicities in stereotactic body radiation therapy (SBRT) for >/=5-cm non-small cell lung cancer (NSCLC), as part of a multi-institutional analysis. METHODS: Patients with primary >/=5-cm N0 M0 NSCLC who underwent /=2 and grade >/=3 toxicities, respectively. Grades 2 and 3 pulmonary toxicities occurred in 9% and 4%, respectively; 1 patient treated daily experienced grade 5 radiation pneumonitis. Of the entire cohort, 46 patients underwent daily SBRT, and 46 received QOD (n=40)/other nondaily (n=6) regimens. Clinical/treatment parameters were similar between groups; the QOD/other group was more likely to receive 3-/4-fraction schemas. Patients treated QOD/other experienced significantly fewer grade >/=2 toxicities as compared with daily treatment (7% vs 43%, P/=2 pulmonary toxicities (P=.014). Patients with peripheral tumors (n=66) were more likely to receive 3-/4-fraction regimens than those with central tumors (n=26). No significant differences in grade >/=2 toxicities were identified according to tumor location (P>.05). CONCLUSIONS: From this multi-institutional study, toxicity of SBRT for >/=5-cm lesions is acceptable, and daily treatment was associated with a higher rate of toxicities.
Journal Title: International journal of radiation oncology, biology, physics
Volume: 97
Issue: 4
ISSN: 1879-355X; 0360-3016
Publisher: Elsevier Inc  
Journal Place: United States
Date Published: 2017
Start Page: 778
End Page: 785
Language: eng
DOI/URL:

S0360-3016(16)33508-8
Notes: LR: 20170228; CI: Copyright (c) 2016; JID: 7603616; 2016/07/12 [received]; 2016/11/21 [revised]; 2016/11/28 [accepted]; ppublish