Local Control for Clinical Stage I Non-small Cell Lung Cancer Treated with Five Fraction Stereotactic Body Radiation Therapy is Not Associated with Treatment Schedule

Publication date: Available online 10 April 2018
Source:Practical Radiation Oncology
Author(s): Pamela Samson, Sana Rehman, Aditya Juloori, Todd DeWees, Michael Roach, Jeffrey Bradley, Gregory M.M. Videtic, Kevin Stephans, Clifford Robinson
PurposeClinical concern remains regarding the relationship between consecutive (QD) versus non-consecutive (QoD) lung SBRT treatment schedules and outcomes for clinical Stage I NSCLC. We examined a multi-institutional series of patients receiving five fraction lung SBRT to compare the local failure rates and overall survival between patients receiving QD versus QoD treatment.Methods and MaterialsLung SBRT databases from two high-volume institutions were combined, and patients receiving five fraction SBRT for a solitary Stage I NSCLC were identified. QD treatment was defined as completing SBRT in ≤7days, while QoD treatment was defined as completing treatment in >7days. To control for patient characteristics between the two institutions, a 1:1 propensity matched analysis was performed. Multivariable logistic regression was performed to identify variables independently associated with local failure, and Cox proportional hazards modeling to identify variables independently associated with increased mortality.ResultsFrom 2005–2016, 245 clinical Stage I NSCLC patients receiving five fraction SBRT were identified. 117 (47.8%) patients received QD treatment and 128 (52.2%) patients received QoD treatment. On propensity matched analysis, no association was seen between QD treatment and local failure (Odds Ratio for QD treatment 0.48, 95% CI 0.12–1.99, p=0.5). On multivariable logistic regression central tumors were independently associated with increased likelihood of local recurrence (OR 5.2, 95% CI 1.11–24.2, p=0.04). Kaplan–Meier analysis identified no difference in median overall survival between QD versus QoD treatments (38.0months versus 38.0months, log-rank p=0.7), respectively. QD treatment was not associated with an increased mortality hazard (HR 1.08, 95% CI 0.67–1.75, p=0.75).ConclusionsThis analysis demonstrated no association between QD versus QoD treatment scheduling and local control or overall survival for early stage NSCLC.



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