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A pilot study of stereotactic body radiation therapy (SBRT) after surgery for stage III non-small cell lung cancer
- Source :
- BMC Cancer, BMC Cancer, Vol 18, Iss 1, Pp 1-8 (2018)
- Publication Year :
- 2018
- Publisher :
- Springer Science and Business Media LLC, 2018.
-
Abstract
- Background Standard therapy for stage III non-small cell lung cancer with chemotherapy and conventional radiation has suboptimal outcomes. We hypothesized that a combination of surgery followed by stereotactic body radiation therapy (SBRT) would be a safe alternative. Methods Patients with stage IIIA (multistation N2) or IIIB non-small cell lung cancer were enrolled from March 2013 to December 2015. The protocol included transcervical extended mediastinal lymphadenectomy (TEMLA) followed by surgical resection, 10 Gy SBRT directed to the involved mediastinum/hilar stations and/or positive surgical margins, and adjuvant systemic therapy. Patients not suitable for anatomic lung resection were treated with 30 Gy to the primary tumor. The primary efficacy end-point was the proportion of patients with grade 3 or higher adverse events (AE) or toxicities. Results Of 10 patients, 7 patients underwent neoadjuvant chemotherapy. All patients had TEMLA. Nine of 10 patients underwent surgical resection. The remaining patient had an unresectable tumor and received 30 Gy SBRT to the primary lesion. All patients had post-operative SBRT. Median follow-up was 18 months. There were no perioperative mortalities. Six patients had any grade 3 AEs with no grade 4–5 AEs. Of these, 4 were not attributable to radiation. Pulmonary-related grade 3 AEs were experienced by 2 patients. There were no failures within the 10 Gy volume. Overall survival and progression-free survival rates at 2 years were 68% (90% CI 36–86) and 40% (90% CI 16–63), respectively. Conclusions In carefully selected patients with locally advanced non-small cell lung cancer, combining surgery with SBRT was well tolerated with no local failure. Trial registration ClinicalTrials.gov identifying number NCT01781741. Registered February 1, 2013.
- Subjects :
- Male
Cancer Research
medicine.medical_specialty
Lung Neoplasms
medicine.medical_treatment
030204 cardiovascular system & hematology
Radiosurgery
lcsh:RC254-282
RT
Post-operative
03 medical and health sciences
0302 clinical medicine
Recurrence
Surgical oncology
Carcinoma, Non-Small-Cell Lung
Positron Emission Tomography Computed Tomography
Genetics
Humans
Medicine
Stage (cooking)
Adverse effect
Adjuvant
SABR
Neoplasm Staging
Postoperative Care
Chemotherapy
business.industry
Mediastinum
Perioperative
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
medicine.disease
Combined Modality Therapy
Magnetic Resonance Imaging
Primary tumor
Surgery
Patient Outcome Assessment
medicine.anatomical_structure
Oncology
030220 oncology & carcinogenesis
Female
Positive Surgical Margin
business
Research Article
Follow-Up Studies
Subjects
Details
- ISSN :
- 14712407
- Volume :
- 18
- Database :
- OpenAIRE
- Journal :
- BMC Cancer
- Accession number :
- edsair.doi.dedup.....4576d8cd4f9362c82d8fa067490923ea
- Full Text :
- https://doi.org/10.1186/s12885-018-5039-5