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Open Access Highly Accessed Research article

Outcomes after stereotactic body radiotherapy for lung tumors, with emphasis on comparison of primary lung cancer and metastatic lung tumors

Takaya Yamamoto1*, Keiichi Jingu1, Yuko Shirata1, Masashi Koto2, Haruo Matsushita1, Toshiyuki Sugawara1, Masaki Kubozono1, Rei Umezawa1, Keiko Abe1, Noriyuki Kadoya1, Youjirou Ishikawa1, Maiko Kozumi1, Noriyoshi Takahashi1, Ken Takeda3 and Yoshihiro Takai4

Author Affiliations

1 Department of Radiation Oncology, Tohoku University School of Medicine, Sendai, Japan

2 Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba, Japan

3 Department of Radiological Technology, School of Health Sciences, Faculty of Medicine, Tohoku University, Sendai, Japan

4 Department of Radiation Oncology, Hirosaki University School of Medicine, Aomori, Japan

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BMC Cancer 2014, 14:464  doi:10.1186/1471-2407-14-464

Published: 23 June 2014

Abstract

Background

The goal of this study was to determine the prognostic factors associated with an improved overall outcome after stereotactic body radiotherapy (SBRT) for primary lung cancer and metastatic lung tumors.

Methods

A total of 229 lung tumors in 201 patients were included in the study. SBRT of 45 Gy in 3 fractions, 48 Gy in 4 fractions, 60 Gy in 8 fractions or 60 Gy in 15 fractions was typically used to treat 172 primary lungs cancer in 164 patients and 57 metastatic lung tumors in 37 patients between January 2001 and December 2011. Prognostic factors for local control (LC) and overall survival (OS) were analyzed using a Cox proportional hazards model.

Results

The median biologically effective dose was 105.6 Gy based on alpha/beta = 10 (BED10). The median follow-up period was 41.9 months. The 3-year LC and OS rates were 72.5% and 60.9%, and the 5-year LC and OS rates were 67.8% and 38.1%, respectively. Radiation pneumonitis of grades 2, 3 and 5 occurred in 22 petients, 6 patients and 1 patient, respectively. Multivariate analyses revealed that tumor origin (primary lung cancer or metastatic lung tumor, p < 0.001), tumor diameter (p = 0.005), BED10 (p = 0.029) and date of treatment (p = 0.011) were significant independent predictors for LC and that gender (p = 0.012), tumor origin (p = 0.001) and tumor diameter (p < 0.001) were significant independent predictors for OS.

Conclusions

SBRT resulted in good LC and tolerable treatment-related toxicities. Tumor origin and tumor diameter are significant independent predictors for both overall survival and local control.

Keywords:
Stereotactic radiotherapy; SBRT; Primary lung cancer; Metastatic lung tumor; Oligometastasis; Prognostic factor