Introduction
Methods
Results
Demographics and lesion characteristics
Variable | Number |
---|---|
Gender: n = 723 patients | |
Male | 349 (48 %) |
Female | 374 (52 %) |
Median age in years (range) | 76 (41–95) |
Median weight in lbs (range) | 160 (60–330) |
Median Karnofsky performance score (range) | 80 (40–100) |
Median VAS Pain Score (range) | 0 (0–9) |
Current or previous smoker | 630 (87 %) |
Median smoker pack/years (range) | 50 (1–545) |
Race/ethnicity | |
Caucasian | 634 (88 %) |
Black/African American | 42 (6 %) |
Hispanic | 5 (0.7 %) |
Other | 2 (0.3 %) |
Unknown | 39 (5 %) |
Medically inoperable | 374 (52 %) |
Surgically inoperable | 111 (15 %) |
Prior Treatment(s): n = 741 lesions | |
None | 622 (84 %) |
Chemotherapy | 69 (9 %) |
Surgery | 17 (2 %) |
External beam radiation | 9 (1 %) |
Radiosurgery | 3 (0.4 %) |
Radiofrequency ablation | 3 (0.4 %) |
Variable | Number |
---|---|
T1N0M0 | 517 (70 %) |
T2N0M0 | 224 (30 %) |
Histology: | |
Adenocarcinoma | 248 (33 %) |
Non-small cell carcinoma | 238 (32 %) |
Squamous cell carcinoma | 224 (30 %) |
Large cell carcinoma | 16 (2 %) |
Bronchiolo-alveolar carcinoma | 15 (2 %) |
Median lesion volume, cc (range) | 14.9 (0.5–334) |
Median lesion size, long axis, cm (range) | 2.4 (0.2–6.5) |
Lesion location | |
Right upper lobe | 197 (27 %) |
Right middle lobe | 38 (5 %) |
Right lower lobe | 116 (16 %) |
Right lobe, NOS | 5 (2 %) |
Left upper lobe | 185 (25 %) |
Left middle lobe | 13 (2 %) |
Left lower lobe | 94 (13 %) |
Left lobe, NOS | 9 (1 %) |
Bronchus | 3 (0.4 %) |
Not indicated | 81 (11 %) |
Median SBRT dose (range), Gy | 54 (10–80) |
Median number of fractions | 3 (1–5) |
Median BED10 dose, Gy | 151.2 (2–240) |
Most common dose/fraction schemes: | |
20 Gy × 3 = 60 Gy | 219 (30 %) |
18 Gy × 3 = 54 Gy | 162 (22 %) |
10 Gy × 5 = 50 Gy | 79 (11 %) |
12.5 Gy × 4 = 50 Gy | 78 (11 %) |
12 Gy × 4 = 48 Gy | 45 (6 %) |
12 Gy × 5 = 60 Gy | 25 (3 %) |
Median Dmax (range), Gy | 72.7 (10–113) |
Median monitor units | 39,373 (5614–102,565) |
SBRT treatment
Organ | Dmax, 25th Percentile (Gy) | Median Dmax (range) | Dmax, 75th Percentile (Gy) | Max dose constraints, RTOG 0236 [7] |
---|---|---|---|---|
Esophagus | 6 | 9.9 Gy (0–51.1) | 16 | 27 Gy max |
Brachial plexus | 4 | 18.6 Gy (0.02–43.5) | 23.5 | 24 Gy max |
Trachea | 7 | 13.5 Gy (0–64.9) | 26 | 30 Gy max |
Main bronchus | 8 | 14.5 Gy (0–63.0) | 28 | 30 Gy max |
Heart | 7 | 12.5 Gy (0–96) | 20 | 30 Gy max |
Major vessels | 10 | 18.3 (0.1–64) | 34 | 39 Gy |
Spinal cord | 4.5 | 7.2 (0–75) | 11.8 | 18 Gy |
Overall survival (OS), local control (LC), and distant disease control (DC)
T stage | BED < 105 Gy | BED 105–149 Gy | BED ≥ 150 Gy |
p value (X
2 test) |
---|---|---|---|---|
T1 | 8/55 (15 %) | 10/92 (11 %) | 18/170 (11 %) | 0.713 |
T2 | 8/25 (32 %) | 9/42 (21 %) | 4/50 (8 %) | 0.029a
|