Stereotaktická radioterapie v léčbě časného stadia nemalobuněčného karcinomu plic
Authors:
K. Resová 1,2; T. Paračková 1,2; J. Cvek 1
Authors‘ workplace:
Onkologická klinika FN Ostrava
1; LF Univerzity Palackého v Olomouci
2
Published in:
Klin Onkol 2023; 36(5): 370-377
Category:
Review
doi:
https://doi.org/10.48095/ccko2023370
Overview
Background: Stereotactic body radiation therapy (SBRT) is now a standard treatment option for patients with early-stage non-small cell lung cancer (ES-NSCLC) who are unfit for surgery or refuse to undergo an operation. SBRT is a method of external beam radiotherapy that accurately delivers a high dose of irradiation in one or few treatment fractions. Intensive regimens of biologically effective dose ≥ 100 Gy are associated with good local control and overall survival, higher than in conventionally fractionated radiotherapy. There are still controversial areas in the SBRT indication where data are limited – indications for elderly and comorbid patients, indications for treatment without histological verification, treatment of central/ultracentral lesions, indications for tumors larger than 5 cm, indications for operable patients. The optimal follow-up practice of these patients also remains unclear, including the frequency of imaging, the use of PET-CT, and requirements for biopsy. CT changes after SBRT differ from those following conventional radiotherapy and it is difficult to distinguish them from tumor recurrence. Due to the high local control achieved with lung SBRT, data on the treatment of local failure are insufficient.
Purpose: The aim of the publication is to demonstrate the current information and the importance of SBRT for patients with ES-NSCLC.
Keywords:
Non-small cell lung cancer – stereotactic body radiotherapy – early-stage lung cancer – stereotactic ablative radiotherapy
Sources
1. Videtic GMM, Donington J, Giuliani M et al. Stereotactic body radiation therapy for early-stage non-small cell lung cancer: Executive Summary of an ASTRO Evidence--Based Guideline. Pract Radiat Oncol 2017; 7 (5): 295–301. doi: 10.1016/j.prro.2017.04.014.
2. Timmerman RD, Paulus R, Galvin J et al. Stereotactic body radiation therapy for medically inoperable early-stage lung cancer patients: analysis of RTOG 0236. Int J Radiat Oncol Biol Phys 2009; 75 (3): S3. doi: 10.1016/j.ijrobp.2009.07.033.
3. Timmerman RD, Hu C, Michalski J et al. Long-term results of RTOG 0236: a phase II trial of stereotactic body radiation therapy (SBRT) in the treatment of patients with medically inoperable stage I non-small cell lung cancer. Int J Radiat Oncol Biol Phys 2014; 90 (1): S30.
4. Guckenberger M. What is the current status of stereotactic body radiotherapy for stage I non-small cell lung cancer? J Thorac Dis 2011; 3 (3): 147–149. doi: 10.3978/ j.issn.2072-1439.2011.06.04.
5. Ball D, Tao Mai G, Vinod S et al. Stereotactic ablative radiotherapy versus standard radiotherapy in stage 1 non--small-cell lung cancer (TROG 09.02 CHISEL): a phase 3, open-label, randomised controlled trial. Lancet Oncol 2019; 20 (4): 494–503. doi: 10.1016/S1470-2045 (18) 30 896-9.
6. Onishi H, Araki T, Shirato H et al. Stereotactic hypofractionated high-dose irradiation for stage I nonsmall cell lung carcinoma: clinical outcomes in 245 subjects in a Japanese multiinstitutional study. Cancer 2004; 101 (7): 1623–1631. doi: 10.1002/cncr.20539.
7. Zhang J, Yang F, Li B et al. Which is the optimal biologically effective dose of stereotactic body radiotherapy for stage I non-small-cell lung cancer? A meta-analysis. Int J Radiat Oncol Biol Phys 2011; 81 (4): e305–e316. doi: 10.1016/j.ijrobp.2011.04.034.
8. Deshpande SR, Grubb WR, Kharouta M et al. A comparative study of patients with early-stage non-small cell lung cancer treated with stereotactic body radiation therapy using CyberKnife and linear akcelerátor-based volumetric modulated arc therapy. Pract Radiat Oncol 2022; 12 (3): 200–209. doi: 10.1016/j.prro.2021.12.011.
9. Diamant A, Heng VJ, Chatterjee A et al. Comparing local control and distant metastasis in NSCLC patients between CyberKnife and conventional SBRT. Radiother Oncol 2020; 144: 201–208. doi: 10.1016/j.radonc.2020.01.017.
10. Liu MB, Eclov NCW, Trakul N et al. Clinical impact of dose overestimation by effective path length calculation in stereotactic ablative radiation therapy of lung tumors. Pract Radiat Oncol 2013; 3 (4): 294–300. doi: 10.1016/j.prro.2012.09.003.
11. Xiao Y, Papiez L, Paulus R et al. Dosimetric evaluation of heterogeneity corrections for RTOG 0236: stereotactic body radiotherapy of inoperable stage I-II non-small-cell lung cancer. Int J Radiat Oncol Biol Phys 2009; 73 (4): 1235–1242. doi: 10.1016/j.ijrobp.2008.11.019.
12. Raz DJ, Zell JA, Ignatius Ou SH et al. Natural history of stage I non-small cell lung cancer: implications for early detection. Chest 2007; 132 (1): 193–199. doi: 10.1378/chest.06-3096.
13. Charlson ME, Pompei P, Ales KL et al. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 1987; 40 (5): 373–383. doi: 10.1016/0021-9681 (87) 90171-8.
14. Kopek N, Paludan M, Petersen J et al. Co-morbidity index predicts for mortality after stereotactic body radiotherapy for medically inoperable early-stage non-small cell lung cancer. Radiother Oncol 2009; 93 (3): 402–407. doi: 10.1016/j.radonc.2009.06.002.
15. Baker S, Sharma A, Peric R et al. Prediction of early mortality following stereotactic body radiotherapy for peripheral early-stage lung cancer. Acta Oncol 2019; 58 (2): 237–242. doi: 10.1080/0284186X.2018.1532602.
16. Klement RJ, Belderbos J, Grills I et al. Prediction of early death in patients with early-stage NSCLC – can we select patients without a potential benefit of SBRT as a curative treatment approach? J Thorac Oncol 2016; 11 (7): 1132–1139. doi: 10.1016/j.jtho.2016.03.016.
17. Haasbeek CJA, Palma D, Visser O et al. Early-stage lung cancer in elderly patients: a population-based study of changes in treatment patterns and survival in the Netherlands. Ann Oncol 2012; 23 (10): 2743–2747. doi: 10.1093/annonc/mds081.
18. Palma D, Visser O, Lagerwaard FJ et al. Impact of introducing stereotactic lung radiotherapy for elderly patients with stage I non-small-cell lung cancer: a population-based time-trend analysis. J Clin Oncol 2010; 28 (35): 5153–5159. doi: 10.1200/JCO.2010.30.0731.
19. Shirvani SM, Jiang J, Chang JY et al. Comparative effectiveness of 5 treatment strategies for early-stage non-small cell lung cancer in the elderly. Int J Radiat Oncol Biol Phys 2012; 84 (5): 1060–1070. doi: 10.1016/ j.ijrobp.2012.07.2354.
20. Palma D, Lagerwaard, Rodrigues G et al. Curative treatment of stage I non-small-cell lung cancer in patients with severe COPD: stereotactic radiotherapy outcomes and systematic review. Int J Radiat Oncol Biol Phys 2012; 82 (3): 1149–1156. doi: 10.1016/j.ijrobp.2011.03.005.
21. Cassidy RJ, Patel PR, Zhang X et al. Stereotactic body radiotherapy for early-stage non-small-cell lung cancer in patients 80 years and older: a multi-center analysis. Clin Lung Cancer 2017; 18 (5): 551–558.e6. doi: 10.1016/ j.cllc.2017.03.006.
22. Bei Y, Murakami N, Nakayama Y et al. Stereotactic body radiation therapy for early-stage non-small-cell lung cancer in octogenarians and older: an alternative treatment. J Radiat Res 2020; 61 (4): 586–593. doi: 10.1093/jrr/rraa027.
23. Brooks ED, Sun B, Zhao L et al. Stereotactic ablative radiation therapy is highly safe and effective for elderly patients with early-stage non-small cell lung cancer. Int J Radiat Oncol Biol Phys 2017; 98 (4): 900–907. doi: 10.1016/ j.ijrobp.2016.12.022.
24. Stiles BM, Servais EL, Lee PC et al. Point: clinical stage IA non-small cell lung cancer determined by computed tomography and positron emission tomography is frequently not pathologic IA non-small cell lung cancer: the problem of understaging. J Thorac Cardiovasc Surg 2009; 137 (1): 13–19. doi: 10.1016/j.jtcvs.2008.09.045.
25. Park HK, Jeon K, Koh WJ et al. Occult nodal metastasis in patients with non-small cell lung cancer at clinical stage IA by PET/CT. Respirology 2010; 15 (8): 1179–1184. doi: 10.1111/j.1440-1843.2010.01793.x.
26. Wiener RS, Wiener DC, Gould MK. Risks of transthoracic needle biopsy: how high? Clin Pulm Med 2013; 20 (1): 29–35. doi: 10.1097/CPM.0b013e31827a30c1.
27. Herder GJ, van Tinteren H, Golding RP et al. Clinical prediction model to characterize pulmonary nodules: validation and added value of 18 F-fluorodeoxyglucose positron emission tomography. Chest 2005; 128 (4): 2490–2496. doi: 10.1378/chest.128.4.2490.
28. Swensen SJ, Silverstein MD, Ilstrup DM et al. The probability of malignancy in solitary pulmonary nodules. Application to small radiologically indeterminate nodules. Arch Intern Med 1997; 157 (8): 849–855.
29. Schultz EM, Sanders GD, Trotter PR et al. Validation of two models to estimate the probability of malignancy in patients with solitary pulmonary nodules. Thorax 2008; 63 (4): 335–341. doi: 10.1136/thx.2007.084731.
30. Louie AV, Senan S, Patel P et al. When is a biopsy-proven diagnosis necessary before stereotactic ablative radiotherapy for lung cancer?: a decision analysis. Chest 2014; 146 (4): 1021–1028. doi: 10.1378/chest.13-2924.
31. Berman AT, Jabbour SK, Vachani A et al. Empiric Radiotherapy for Lung Cancer Collaborative Group multi-institutional evidence-based guidelines for the use of empiric stereotactic body radiation therapy for non-small cell lung cancer without pathologic confirmation. Transl Lung Cancer Res 2019; 8 (1): 5–14. doi: 10.21037/tlcr.2018.12.12.
32. Wegner RE, Ahmed N, Hasan S et al. SBRT for early stage lung cancer: outcomes from biopsy-proven and empirically treated lesions. Lung Cancer Manag 2018; 7 (1): LMT01. doi: 10.2217/lmt-2018-0006.
33. Timmerman R, McGarry R, Yiannoutsos C et al. Excessive toxicity when treating central tumors in a phase II study of stereotactic body radiation therapy for medically inoperable early-stage lung cancer. J Clin Oncol 2006; 24 (30): 4833–4839. doi: 10.1200/JCO.2006.07.5937.
34. Senthi S, Haasbeek CJA, Slotman BJ et al. Outcomes of stereotactic ablative radiotherapy for central lung tumours: a systematic review. Radiother Oncol 2013; 106 (3): 276–282. doi: 10.1016/j.radonc.2013.01.004.
35. Corradetti MN, Haas AR, Rengan R. Central-airway necrosis after stereotactic body-radiation therapy. N Engl J Med 2012; 366 (24): 2327–2329. doi: 10.1056/NEJMc1203770.
36. Chang JY, Balter PA, Dong L et al. Stereotactic body radiation therapy in centrally and superiorly located stage I or isolated recurrent non-small-cell lung cancer. Int J Radiat Oncol Biol Phys 2008; 72 (4): 967–971. doi: 10.1016/j.ijrobp.2008.08.001.
37. Bezjak A, Paulus R, Gaspar LE et al. Safety and efficacy of a five-fraction stereotactic body radiotherapy schedule for centrally located non-small-cell lung cancer: NRG oncology/RTOG 0813 trial. J Clin Oncol 2019; 37 (15): 1316–1325. doi: 10.1200/JCO.18.00622.
38. Timmerman R, Paulus R, Galvin J et al. Stereotactic body radiation therapy for inoperable early stage lung cancer. JAMA 2010; 303 (11): 1070–1076. doi: 10.1001/jama.2010.261.
39. Chang JY, Bezjak A, Mornex F. Stereotactic ablative radiotherapy for centrally located early stage non-small-cell lung cancer: what we have learned. J Thorac Oncol 2015; 10 (4): 577–585. doi: 10.1097/JTO.0000000000000453.
40. Bezjak A, Paulus R, Gaspar LE et al. Primary study endpoint analysis for NRG oncology/RTOG 0813 trial of stereotactic body radiation therapy (SBRT) for centrally located non-small cell lung cancer (NSCLC). Int J Radiat Oncol Biol Phys 2016; 94 (1): 5–6. doi: 10.1016/j.ijrobp.2015.10.040.
41. Nuyttens JJ, van der Voort van Zyp NC, Praag J et al. Outcome of four-dimensional stereotactic radiotherapy for centrally located lung tumors. Radiother Oncol 2012; 102 (3): 383–387. doi: 10.1016/j.radonc.2011.12.023.
42. Haasbeek CJA, Lagerwaard FJ, Slotman BJ et al. Outcomes of stereotactic ablative radiotherapy for centrally located early-stage lung cancer. J Thorac Oncol 2011; 6 (12): 2036–2043. doi: 10.1097/JTO.0b013e31822e71d8.
43. Adebahr S, Collette S, Shash E et al. LungTech, an EORTC Phase II trial of stereotactic body radiotherapy for centrally located lung tumours: a clinical perspective. Br J Radiol 2015; 88 (1051): 20150036. doi: 10.1259/bjr.20150036.
44. Tran JH, Mhango G, Park HS et al. Outcomes following SBRT vs. IMRT and 3DCRT for older patients with stage IIA node-negative non-small cell lung cancer > 5 cm. Clin Lung Cancer 2023; 24 (1): e9–e18. doi: 10.1016/ j.cllc.2022.10.006.
45. Woody NM, Stephans KL, Marwaha G et al. Stereotactic body radiation therapy for non-small cell lung cancer tumors greater than 5 cm: safety and efficacy. Int J Radiat Oncol Biol Phys 2015; 92 (2): 325–331. doi: 10.1016/ j.ijrobp.2015.01.045.
46. Peterson J, Niles C, Patel A et al. Stereotactic body radiotherapy for large (> 5 cm) non-small-cell lung cancer. Clin Lung Cancer 2017; 18 (4): 396–400. doi: 10.1016/ j.cllc.2016.11.020.
47. Chang JY, Senan S, Paul MA et al. Stereotactic ablative radiotherapy versus lobectomy for operable stage I non-small-cell lung cancer: a pooled analysis of two randomised trials. Lancet Oncol 2015; 16 (6): 630–637. doi: 10.1016/S1470-2045 (15) 70168-3.
48. Chang JY, Mehran RJ, Feng L et al. Stereotactic ablative radiotherapy for operable stage I non-small-cell lung cancer (revised STARS): long-term results of a single-arm, prospective trial with prespecified comparison to surgery. Lancet Oncol 2021; 22 (10): 1448–1457. doi: 10.1016/S1470-2045 (21) 00401-0.
49. Spencer KL, Kennedy MPT, Lummis KL et al. Surgery or radiotherapy for stage I lung cancer? An intention-to-treat analysis. EUR Respir J 2019; 53 (6): 1801568. doi: 10.1183/13993003.01568-2018.
50. Detillon DDEMA, Aarts MJ, De Jaeger K et al. Video-assisted thoracic lobectomy versus stereotactic body radiotherapy for stage I nonsmall cell lung cancer in elderly patients: a propensity matched comparative analysis. Eur Respir J 2019; 53 (6): 1801561. doi: 10.1183/13993003.01561-2018.
51. Schneider BJ, Daly ME, Kennedy EB et al. Stereotactic body radiotherapy for early-stage non-small-cell lung cancer: American society of clinical oncology endorsement of the American society for radiation oncology evidence-based guideline. J Clin Oncol 2018; 36 (7): 710–719. doi: 10.1200/JCO.2017.74.9671.
52. Nguyen TK, Senan S, Bradley JD et al. Optimal imaging surveillance after stereotactic ablative radiation therapy for early-stage non-small cell lung cancer: findings of an International Delphi Consensus Study. Pract Radiat Oncol 2018; 8 (2): e71–e78. doi: 10.1016/j.prro.2017.10.008.
53. Huang K, Dahele M, Senan S et al. Radiographic changes after lung stereotactic ablative radiotherapy (SABR) – can we distinguish recurrence from fibrosis? A systematic review of the literature. Radiother Oncol 2012; 102 (3): 335–342. doi: 10.1016/j.radonc.2011.12.018.
54. Dahele M, Palma D, Lagerwaard F et al. Radiological changes after stereotactic radiotherapy for stage I lung cancer. J Thorac Oncol 2011; 6 (7): 1221–1228. doi: 10.1097/JTO.0b013e318219aac5.
55. Guckenberger M, Heilman K, Wulf J et al. Pulmonary injury and tumor response after stereotactic body radiotherapy (SBRT): results of a serial follow-up CT study. Radiother Oncol 2007; 85 (3): 435–442. doi: 10.1016/j.radonc.2007.10.044.
56. Takeda A, Kunieda E, Takeda T et al. Possible misinterpretation of demarcated solid patterns of radiation fibrosis on CT scans as tumor recurrence in patients receiving hypofractionated stereotactic radiotherapy for lung cancer. Int J Radiat Oncol Biol Phys 2008; 70 (4): 1057–1065. doi: 10.1016/j.ijrobp.2007.07.2383.
57. Kato S, Nambu A, Onishi H et al. Computed tomography appearances of local recurrence after stereotactic body radiation therapy for stage I non-small-cell lung carcinoma. Jpn J Radiol 2010; 28 (4): 259–265. doi: 10.1007/s11604-009-0415-3.
58. Zhang X, Liu H, Balter P et al. Positron emission tomography for assessing local failure after stereotactic body radiotherapy for non-small-cell lung cancer. Int J Radiat Oncol Biol Phys 2012; 83 (5): 1558–1565. doi: 10.1016/ j.ijrobp.2011.10.035.
59. Henderson MA, Hoopes DJ, Fletcher JW et al. A pilot trial of serial 18F-fluorodeoxyglucose positron emission tomography in patients with medically inoperable stage I non-small-cell lung cancer treated with hypofractionated stereotactic body radiotherapy. Int J Radiat Oncol Biol Phys 2010; 76 (3): 789–795. doi: 10.1016/ j.ijrobp.2009.02.051.
60. Palma DA, Nguyen TK, Kwan K et al. Short report: interim safety results for a phase II trial measuring the integration of stereotactic ablative radiotherapy (SABR) plus surgery for early stage non-small cell lung cancer (MISSILE-NSCLC). Radiat Oncol 2017; 12 (1): 30. doi: 10.1186/s13014-017-0770-7.
61. Brooks ED, Verma V, Senan S et al. Salvage therapy for locoregional recurrence after stereotactic ablative radiotherapy for early-stage NSCLC. J Thorac Oncol 2020; 15 (2): 176–189. doi: 10.1016/j.jtho.2019.10.016.
62. Brooks ED, Sun B, Feng L et al. Association of long-term outcomes and survival with multidisciplinary salvage treatment for local and regional recurrence after stereotactic ablative radiotherapy for early-stage lung cancer. JAMA Netw Open 2018; 1 (4): e181390. doi: 10.1001/jamanetworkopen.2018.1390.
63. Kennedy WR, Gabani P, Nikitas J et al. Repeat stereotactic body radiation therapy (SBRT) for salvage of isolated local recurrence after definitive lung SBRT. Radiother Oncol 2020; 142: 230–235. doi: 10.1016/j.radonc.2019.08.010.
64. Hearn JWD, Videtic GMM, Djemil T et al. Salvage stereotactic body radiation therapy (SBRT) for local failure after primary lung SBRT. Int J Radiat Oncol Biol Phys 2014; 90 (2): 402–406. doi: 10.1016/j.ijrobp.2014.05.048.
Labels
Paediatric clinical oncology Surgery Clinical oncologyArticle was published in
Clinical Oncology
2023 Issue 5
Most read in this issue
- Léčba dospělých pacientů s akutní lymfoblastovou leukemií v České republice v letech 2007–2020
- Transformace indolentního folikulární lymfomu v difuzní velkobuněčný B-lymfom – molekulární podstata „nádorové agresivity“
- Stereotaktická radioterapie v léčbě časného stadia nemalobuněčného karcinomu plic
- Využití botulotoxinu při léčbě nežádoucích účinků radioterapie