Prognostic Factors for Overall and Disease-specific Survival of Stage I Non-Small-Cell Lung Cancer after Stereotactic Body Radiotherapy: A Retrospective Analysis

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  • Abe Tatsuyuki
    Department of Radiology, St. Marianna University School of Medicine
  • Okada Yukinori
    Department of Radiology, St. Marianna University School of Medicine
  • Shinozaki Mio
    Department of Radiology, St. Marianna University School of Medicine
  • Tanaka Akiko
    Department of Radiology, St. Marianna University School of Medicine
  • Kobayashi Mariko
    Department of Radiology, St. Marianna University School of Medicine
  • Gomi Hiromichi
    Department of Radiology, St. Marianna University School of Medicine

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<p>Background: The purpose of this study was to investigate the prognostic factors of stereotactic body radiotherapy (SBRT) for stage I non-small-cell lung cancer (NSCLC) to improve outcomes.<br/>Materials and methods: Between 2008 and 2016, 71 patients with medically inoperable stage I NSCLC were treated at our hospital with SBRT (48–55 Gy in 4–5 fractions for peripheral lesions or 60–64 Gy in 8–10 fractions for central lesions). Survival outcomes were analyzed using Kaplan-Meier and cumulative incidence methods. Factors including sex, age, tumor location, tumor size, BED (biologically effective dose) 10, and maximum standardized uptake value (SUVmax) were evaluated with regard to overall survival (OS) and disease-specific survival (DSS) using Cox proportional hazard regression.<br/>Results: The median follow-up duration of surviving patients was 33 months (range, 6–81 months). Two-year OS and DSS were 78.5% and 91.5%, respectively. Two-year cumulative local recurrence rate, regional recurrence rate, and distant metastasis rate were 6.8%, 10.9%, and 7.3%, respectively. Multivariate analysis revealed that BED10 and SUVmax were prognostic factors for DSS.<br/>Conclusion: Lower BED10 and higher SUVmax were predictors of significantly worse DSS. A higher SUVmax may be considered for intensive treatment to improve outcomes.</p>

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