The application of gamma stereotactic body radiation therapy in stage I/II non-small-cell lung cancer. Promising and encouraging outcome

OBJECTIVE: To further evaluate the efficacy and toxicity of the gamma-ray stereotactic body radiation therapy (SBRT) in patients with stage I/II non-small-cell lung cancer (NSCLC).

METHODS: Twenty-nine newly diagnosed patients with stage I/II NSCLC who had no previous treatments, underwent OUR-QGD type of the gamma-SBRT at the Radiation Oncology Department, People's Liberation Army Airforce General Hospital, Beijing, China from January 2007 to July 2010. All patients were immobilized by vacuum bag, and then a slow CT scan was performed without any respiration gating. The total radiation dose of 50%, 60%, and 70% isodose line were prescribed in 50, 60, and 70 Grey (Gy) correspondingly, covering 100% of the planning target volume (PTV), 90% of the clinical target volume (CTV), and 80% of the gross target volume (GTV) in 10 fractions. The CT scans of the chest were required at one, 3, 6, 12, 18, and 24 months to evaluate the efficacy of the treatment.

RESULTS: The median follow-up duration was 24 months, and the final follow-up rate is 96.6%. Local control rates of one and 2 years were all 93.1%. The progression-free survival rates versus overall survival rate of one year was 89.7% versus 96.6%, and 2 years was 86.1% versus 89.4%. Acute radiation reactions was diagnosed in 34.5%, and late radiation reactions in 37.9% of patients.

CONCLUSION: The gamma-SBRT results in a good curative effects, and minimal toxicity in the treatment of stage I/II NSCLC.