Table 2. Retrospective 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| Song et al. [2008] (22) | No | T1-2aN0; N=32 | RTOG 0236 | 10 Gy ×4; 12 Gy ×4; 20 Gy ×3 (peripheral) | No | 27 | 2 y-OS: 38.5%; central vs. peripheral: 2 y-OS: 50.0% vs. 35.4%, P=0.85 | 2 y-LC: 85.3%; central vs. peripheral: 2 y-LC: 88.9% vs. 84.2%, P=0.97 |
33 | 11%; 1× hemorrhage/pneumonia |
| Oshiro et al. [2010] (23) | Yes | T1-2aN0; N=21 | RTOG 0236 | – | No | 20 | 2 y-OS: 62.2% | – | 14 | 10%; 1× hemorrhage; 1× pneumonia |
| Haasbeek et al. [2011] (14) | Yes | T1-3N0; N=63 | RTOG 0236 | 7.5 Gy ×8 | No | 35 | 2 y-OS: 69.0%; 5 y-OS: 49.5% | 2 y-LC: 92.6%; 5 y-LC: 92.6% | 6 | 0% |
| Rowe et al. [2012] (24) | Yes | T1-2N0; N=47 | RTOG 0813 | 12.5 Gy ×4 | Yes | 11 | – | 2 y-LC: 94% | 11 | 2%; 1× hemorrhage |
| Chang et al. [2014] (25) | Yes | T1-2N0; N=100 | Adapted MD Anderson definition | 7 Gy ×10; 12.5 Gy ×4 | Yes | 31 | 3 y-OS: 70.5%; 5 y-OS: 49.5%; MS: 55.6 months; 5 y-PFS: 63.6% | 3 y-LC: 96.5% | 1 | 0% |
| Modh et al. [2014] (26) | Yes | T1-4N0; OR M1; N=125 | RTOG 0236 | 6 Gy ×5; 8 Gy ×5; 9 Gy ×5; 10 Gy ×5; 10 Gy ×4; 11 Gy ×4; 12 Gy ×4; 12 Gy ×3; 18 Gy ×3; 20 Gy ×3; 18 Gy ×2 | – | 17 | 2 y-OS: 64%; MS: 29.1 months | 2 y-LC: 79% | 8 | 2% |
| Chaudhuri et al. [2015] (27) | No | T1-3N0; N=68 | RTOG 0813 | 10 Gy ×5; 12.5 Gy ×4 | Yes | 18 | 2 y-OS: 73.8%; MS: 38.1 months; central vs. peripheral: no significant difference | – | 3 | 0% |
| Davis et al. [2015] (28) | Yes | T1-2N0; N=48 | Adapted MD Anderson definition | 12 Gy ×4; variable | – | 17 | 2 y-OS: 79% (T1), 32.1% (T2); MS: 26 months | 2 y-LC: 76.4% | 0 | 0% |
| Park et al. [2015] (29) | No | T1-2N0; N=251 | RTOG 0813 + 1cm from spinal canal | 10 Gy ×5; 12.5 Gy ×4; 18 Gy ×3 | Yes | 31 | Central vs. peripheral: 2 y-OS: 71.6% vs. 71.0%; MS: 34.8 months | Central vs. peripheral: 2 y-LC: 87.1% vs. 88.6%, P=1.00 | 8 | 1%; 1× hemorrhage |
| Tekatli et al. [2015] (15) | Yes | T1-3N0; OR M1; N=80 | PTV within Central Zone | 7.5 Gy ×8 | – | 45 | Central vs. peripheral: 3 y-OS: 53% vs. 57%, P=0.369; MS: 38 vs. 44 months | – | 14 | 8%; 2× hemorrhage; 1× radiation pneumonitis; 1× terminal respiratory failure; 1× euthanasia; 1× sudden death |
| Haseltine et al. [2016] (30) | Yes | T1-2aN0; N=108 | RTOG 0813 | 9 Gy ×5; 10 Gy ×5; 12 Gy ×4 | – | 23 | 2 y-OS: 63.9% | 2 y-LC: 77.4% | 12 | 4%; (2× hemorrhage); 2× pneumonia; (Both had anti-VEGF therapy) |
| Miyakawa et al.[2017] (31) | No | T1-2aN ; N=71 | RTOG 0236 | 12 Gy ×4; 12.5 Gy ×4; 13 Gy ×4 | – | 44 | 5 y-OS: 65%; 5 y-PFS: 55% | 5 y-LC: 85% | 13 | – |
| Stephans et al. [2018] (32) | No | T1-3N0; N=662 | RTOG 0236 | 5 Gy ×10; 7.5 Gy ×8; 10 Gy ×5 | Yes | 20 | MS: 32 months | 2 y-LC: 86.9% | – | – |
SBRT, stereotactic body radiation therapy; NSCLC, non-small cell lung cancer; RTOG, Radiation Therapy Oncology Group; Gy, gray; OS, overall survival; LC, local control; MS, median survival; PFS, progression-free survival; PTV, planning target volume.