Table 1. Prospective studies reporting toxicity and outcomes of SBRT for patients with centrally located NSCLC.
Reference | Central only | Stage and patient number | Definition of “Central Tumors” | SBRT dose | Heterogeneity correction | Median follow-up (months) | Survival | Local control | Grade 3+ toxicities (%) | Grade 5 toxicities |
---|---|---|---|---|---|---|---|---|---|---|
Timmerman et al. [2006] (11); Phase II | No | T1-2N0, N=70 | GTV within central zone (RTOG 0236) | 20 Gy ×3; 22 Gy ×3 | No | 18 | MS: 32.6 months; central vs. peripheral: no difference | 2 y-LC: 95% | 46 | 1× hemorrhage; 1× pericardial effusion; 4× bacterial pneumonia |
Xia et al. [2006] (4); Phase II | No | T1-2N0, N=43 | – | 7 Gy ×10 | No | 27 | 3 y-OS: Stage 1, 91%; Stage 2, 64% | 3 y-LC: 95% | 0 | 0% |
Fakiris et al. [2009] (Update of Timmerman study) (3); Phase II | No | T1-2N0, N=70 | Same as Timmerman et al. [2006] | 20 Gy ×3; 22 Gy ×3 | No | 50 | 3 y-OS: 42.7%; MS: 32.4 months; central vs. peripheral: 24.4 vs. 33.2 months, P=0.697 | 3 y-LC: 88% | 27 | 1× hemorrhage; 1× respiratory failure; 3× bacterial pneumonia |
Bral et al. [2011] (20); Phase II | No | T1-2N0, N=40 | RTOG 0813 | 15 Gy ×4; 20 Gy ×3 (peripheral) | No | 16 | 2 y-OS: 52%; 2 y-PFS: 64%; central vs. peripheral (1-y metastasis-free survival): 79% vs. 91%, P=0.54 | 2 y-LC: 84% | 29 | 0%; (Patient with grade 3 stenosis died of hemoptysis after stenting) |
RTOG 0813; Bezjak et al. [2016] (13); Phase I/II | Yes | T1-2aN0, N=120 | GTV within central zone, PTV overlapping w mediastinum (RTOG 0813) | 10 Gy ×5; 10.5 Gy ×5; 11 Gy ×5; 11.5 Gy ×5; 12 Gy ×5 | Yes | 33 | 2 y-OS: 72.7%; 2 y-PFS: 54.5% |
2 y-LC: 87.7% | 18 | 6%; 3× hemorrhage; 1× esophageal ulcer |
Roach et al. [2018] (21); Phase I/II | Yes | T1-3N0, N=64 | RTOG 0236 | 9 Gy ×5; 10 Gy ×5; 11 Gy ×5; 12 Gy ×5 | – | 12 | 1 y-OS: 81.2% | 1 y-LC: 95.4% | 17 | 2%; 1× hemorrhage |
SBRT, stereotactic body radiation therapy; NSCLC, non-small cell lung cancer; GTV, gross tumor volume; RTOG, Radiation Therapy Oncology Group; Gy, gray; MS, median survival; LC, local control; OS, overall survival; PFS, progression-free survival; PTV, planning target volume.