Stereotactic Ablative Radiotherapy

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Stereotactic Ablative Radiotherapy Demonstrated Longer Overall Survival In Multiple Primary Lung Cancer: MD Anderson

A research team led by Joe Y. Chang, MD, PhD, of the department of radiation oncology at The University of Texas MD Anderson Cancer Center examined the use of stereotactic ablative radiotherapy in patients with multiple primary lung cancer, and demonstrated long-term tumor control and increased OS (overall survival) and PFS (progression free survival) according to study results. Multiple primary lung cancer incidence has increased steadily in recent years. Although surgical resection has been the standard form of treatment, many patients are unable to undergo surgery, according to background information provided by researchers.

In the study, 101 patients (57% men, median age 72 years, range of age 50-90 years) were examined, and tumors were treated with stereotactic ablative radiotherapy 50 Gy in four fractions (n=120) or 70 Gy in 10 fractions (n=10). Gy (gray) is defined as the absorption of one joule of ionizing radiation by one kilogram (1 J/kg) of matter such as human tissue.

As a result, median OS was 46 months. The researchers reported OS rates of 73.2% at 2 years and 47.5% at 4 years – PFS rates of 67% at 2 years and 58% at 4 years.

Patients with metachronous tumors demonstrated improved survival compared with those who had synchronous tumors. With metachronous tumors vs. synchronous tumors, OS rates were 80.6% vs. 61.5% and PFS rates were 84.7% vs. 49.4% at 2 years. At 4 years, OS rates were 52.7% vs. 39.7% and 39.7% vs. 30.4%.

Grade ≥3 radiation pneumonitis occurred in 3% of patients who underwent surgery or received stereotactic ablative radiotherapy for an index tumor. The incidence increased to 17% for patients who received conventional radiotherapy for an index tumor. Other grade ≥3 toxicities were chest wall pain (3%) and skin toxicity (1%).

“Stereotactic ablative radiotherapy achieves promising long-term tumor control and survival and may be a potential curative treatment for early-stage multiple primary lung cancer,” Chang and colleagues concluded.