Table 2.
Summary of recent studies reporting outcomes of SBRT for stage I NSCLC.
| Author, year, and type of study |
Reference Number | Center | Number of patients (stage IA/IB) | Patient age (y) | Tumor size (cm) | Follow-up period (mo) | Toxicities | Local efficacy | Survival |
|---|---|---|---|---|---|---|---|---|---|
| Onishi et al., 2004 | [24] | Yamanashi Medical University in Japan | 35 (15/20) | 78* | 33** | 13* | No grade ≥3 toxicities | Proportion of LTP: 6% | 2-year OS and CSS: 58% and 83%, respectively |
|
| |||||||||
| Nagata et al., 2005, prospective | [25] | Kyoto University in Japan | 45 (32/13) | 77* for stage IA and 73* for stage IB |
<4.0 | 30* for stage IA and 22* for stage IB |
No grade ≥3 pulmonary toxicities | Proportion of LTP: 2% | 1-/2-/3-/5-year OS and DFS for stage IA: 93%/90%/83%/83% and 80%/72%/72%, respectively 1-/2-/3-/5-year OS and DFS for stage IB: 82%/72%/72%/72% and 92%/71%/71%/71%, respectively |
|
| |||||||||
| Zimmermann et al., 2005 | [26] | Technical University in Germany | 30 (5/25) | 60–69 (n = 10) 70–79 (n = 14) ≥80 (n = 6) |
NA | 18* for alive patients | No grade 5 or 4 toxicities and grade 3 pneumonitis: 3% | Proportion of LTP: 7% and 2-year LTP: 13% |
1-/2-year OS: 80%/75%, respectively |
|
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| Nyman et al., 2006 | [27] | Sahlgrenska University in Sweden | 45 (18/27) | 74* | 3.5** | 43* | No grade 5 toxicities and no grade ≥2 radiation pneumonitis | Proportion of LTP: 20% | 1-/2-/3-/5-year OS and CSS: 80%/71%/55%/30% and 88%/83%/67%/41%, respectively, and median OS and CSS: 39 mo and 55 mo, respectively |
|
| |||||||||
| Timmerman et al., 2006, prospective | [28] | Indiana University in US | 70 (35/35) | 70* | NA | 18* | Grade 5 toxicities: 9% (including pneumonia [6%], pericardial effusion [1%], hemoptysis [1%]) and grade 3 or 4 toxicities: 11% | Proportion of LTP: 4% and 2-year LTP: 5% |
2-year OS: 55% and median OS: 33 mo |
|
| |||||||||
| Onishi et al., 2007, retrospective | [29] | Multicenter in Japan | 257 (164/93) | 74* | 2.8* | 38* | No mortality and grade ≥3 pulmonary toxicities: 5% | Proportion of LTP: 14%, | 3-/5-year OS and CSS: 57%/47% and 77%/73%, respectively |
|
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| Baumann et al., 2009, prospective | [30] | Multicenter in Sweden, Norway, and Denmark | 57 (40/17) | 75* | 2.5* | 35* | No grade 5 toxicities and grade 4/3 toxicities: 2%/28%, respectively | Proportion of LTP: 7% and 3-year LTP: 8% |
1-/2-/3-year OS and CSS: 85%/65%/60% and 93%/88%/88%, respectively, and median OS: 41 mo |
|
| |||||||||
| Fakiris et al., 2009, prospective | [31] | Indiana University in US | 70 (34/36) | NA | NA | 50* | Grade 5 toxicities: 7% (including pneumonia [4%], hemoptysis [1%], and respiratory failure [1%]) and grade 4/3 toxicities: 1%/9%, respectively |
Proportion of LTP: 6%, 3-year LTP: 12% |
3-year OS/CSS: 43%/82%, respectively, median OS: 32 mo, and median OS for stages IA and IB: 39 mo and 25 mo, respectively |
|
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| Ricardi et al., 2010, prospective | [32] | University of Torino in Italy | 62 (43/19) | 74* | 2.4* | 28* | No grade 5 toxicities and grade ≥3 radiation pneumonitis: 3% | Proportion of LTP: 6%, 3-y LTP: 12% |
2-/3-year OS, CSS, and DFS: 69%/57%, 79%/73%, and 63%/55%, respectively |
|
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| Timmerman et al., 2010, prospective | [33] | Multicenter in US and Canada | 55 (44/11) | 72* | ≤5.0 | 34* | No grade 5 toxicities and grade 4/3 toxicities: 4%/13%, respectively | Proportion of LTP: 2%, 3-y LTP: 2% |
3-year OS/DFS: 56%/48%, respectively, and median OS and DFS: 48 mo and 34 mo, respectively |
|
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| Onishi et al., 2011, retrospective | [34] | Multicenter in Japan | 87 (64/23) | 74* | 2.1* for stage IA and 3.9* for stage IB | 55* | No grade 5 toxicities, grade 3 pulmonary toxicities: 1%, and overall grade 3 toxicities: 9% |
Overall proportion of LTP: 9%, 5-year overall LTP: 13%, and 5-year LTP for stages IA and IB: 8% and 27%, respectively |
5-year OS/CSS: 70%/76%, respectively, and 5-year OS for stages IA and IB: 72% and 63%, respectively |
|
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| Lagerwaard et al., 2012, prospective | [35] | VU University Medical Center in Netherlands | 177 (106/71) | 76* | 2.6* | 32* | No grade 5 toxicities and grade ≥3 radiation pneumonitis: 2% | Proportion of LTP: 5% and 1-/3-year LTP: 2%/7%, respectively |
1-/3-/5-year OS: 95%/85%/51%, respectively, and median OS: 62 mo |
|
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| Shibamoto et al., 2012, prospective | [36] | Multicenter in Japan | 180 (128/52) | 77* | 2.7* | 36* | No grade 5 toxicities and grade 3 radiation pneumonitis: 1% | 3-year LTP: 17% | 3-/5-year OS: 69%/52%, respectively, and 3-year OS/CSS for stages IA and IB: 78%/88% and 60%/69%, respectively |
|
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| Crabtree et al., 2014, retrospective | [37] | Washington University in US | 151 (110/41) | 74** | 2.6** | 23* | NA | Proportion of LTP: 11% | 1-/3-/5-year OS and DFS: 82%/47%/25% and 79%/42%/19%, respectively |
*Median values, **mean values, SBRT = stereotactic body radiation therapy, NSCLC = nonsmall cell lung cancer, NA = not available, LTP = local tumor progression, OS = overall survival, CSS = cancer-specific survival, and DFS = disease-free survival.