Stereotactic Body Radiation Therapy (SBRT) for Recurrent Non-small Cell Lung Cancer (NSCLC)

Abstract

Aim: For local recurrence of non-small cell lung cancer (NSCLC), stereotactic body radiation therapy (SBRT) has become increasingly popular. Many patients with recurrent NSCLC are unable to receive high-dose SBRT [biologically effective dose (BED) >100 Gy] due to poor performance status and potential normal tissue damage.

Patients and methods: Thirty-one patients receiving lower-dose SBRT with a BED of 57.6 to 96.0 Gy, were analyzed for local control, freedom from distant progression and survival.

Results: In the entire series, local control rates were 96% at 1, 2 and 3 years. Freedom from distant progression rates were 74%, 65% and 65%, respectively, and survival rates were 87%, 65% and 65%, respectively. On multivariate analysis, freedom from distant progression was significantly associated with absence of distant metastases (p=0.009), and survival with BED >75 Gy (p=0.039).

Conclusion: SBRT with BED <100 Gy provided very promising outcomes when administered for recurrent NSCLC. A BED >75 Gy is recommended, which was superior to lower doses.

Keywords: Non-small cell lung cancer; biologically effective dose; local recurrence; stereotactic body radiation therapy.