Clinical outcomes of 130 patients with primary and secondary lung tumors treated with Cyberknife robotic stereotactic body radiotherapy

  • Zsolt Levente Janvary Division of Radiotherapy, Department of Clinical Oncology, Faculty of Medicine, University of Debrecen, Debrecen, HUNGARY http://orcid.org/0000-0002-4583-4901
  • Nicolas Jansen Department of Radiation Oncology, Liege University Hospital, Liege, Belgium
  • Veronique Baart Department of Radiation Oncology, Liege University Hospital, Liege, Belgium
  • Magali Devillers Department of Radiation Oncology, Liege University Hospital, Liege, Belgium
  • David Dechambre Department of Radiation Oncology, Liege University Hospital, Liege, Belgium
  • Eric Lenaerts Department of Radiation Oncology, Liege University Hospital, Liege, Belgium
  • Laurence Seidel Department of Biostatistics, Liege University Hospital, Liege, Belgium
  • Nicole Barthelemy Department of Radiation Oncology, Liege University Hospital, Liege, Belgium
  • Patrick Berkovic Department of Radiation Oncology, Liege University Hospital, Liege, Belgium
  • Akos Gulyban Department of Radiation Oncology, Liege University Hospital, Liege, Belgium
  • Ferenc Lakosi Department of Radiation Oncology, Liege University Hospital, Liege, Belgium
  • Zsolt Horvath Division of Radiotherapy, Department of Clinical Oncology, Faculty of Medicine, University ofDebrecen, Debrecen, Hungary
  • Philippe A. Coucke Department of Radiation Oncology, Liege University Hospital, Liege, Belgium

Abstract

Background: Authorsreport clinical outcomes of patients treated with robotic stereotactic body radiotherapy (SBRT) for primary, recurrent and metastatic lung lesions.

Materials and methods: 130 patients with  160 lesions were treated with Cyberknife SBRT,including T1-3 primary lung cancers (54 %), recurrent tumors (22%) and pulmonary metastases (24%).  The mean biologically equivalent dose (BED10Gy) was 151 Gy (72-180 Gy). Median prescribed dose for peripheral and central lesions was 3x20 Gy and 3x15 Gy, respectively. Local control (LC), overall survival (OS), and cause-specific survival (CSS) rates, early and late toxicitiesare reported. Statistical analysis was performed to identify factors influencing local tumor control.

Results: Median follow-up time was 21 months. In univariate analysis, higher dose was associated with better LC and a cut-off value was detected at BED10Gy≤112.5 Gy, resulting in 1-, 2-, and 3-year actuarial LC rates of 93%, vs 73%, 80% vs 61%, and 63% vs 54%, for the high and low dose groups, respectively (p=0.0061, HR=0.384). In multivariate analysis, metastatic origin, histological confirmation and larger Planning Target Volume (PTV) were associated with higher risk of local failure. Actuarial OS and CSS rates at 1, 2, and 3 years were 85%, 74% and 62%, and 93%, 89% and 80 %, respectively. Acute and late toxicities ≥ Gr 3 were observed in 3 (2%) and 6 patients (5%), respectively.

Conclusion: Our favorable LC and survival rates after robotic SBRT are coherent with the literature in this mixed, non-selected study population, with low rates of severe toxicities.
Published
2017-06-07
How to Cite
Janvary, Z. L., Jansen, N., Baart, V., Devillers, M., Dechambre, D., Lenaerts, E., Seidel, L., Barthelemy, N., Berkovic, P., Gulyban, A., Lakosi, F., Horvath, Z., & Coucke, P. A. (2017). Clinical outcomes of 130 patients with primary and secondary lung tumors treated with Cyberknife robotic stereotactic body radiotherapy. Radiology and Oncology, 51(2). Retrieved from https://radioloncol.com/index.php/ro/article/view/2739
Section
Clinical oncology