Partial Stereotactic Ablative Radiotherapy Boost Before Conventional Radiotherapy (P‐SABR) for Large (> 5 cm) Unresectable Stage III Nonsmall Cell Lung Cancer
ABSTRACT Objective Stereotactic ablative radiotherapy (SABR) is renowned for its high local control (LC) rates. Nonetheless, for tumors that are either large in volume or in close proximity to critical organs at risk, the application of SABR to the entire tumor becomes impractical. This study aims t...
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Wiley
2025-01-01
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| Series: | Thoracic Cancer |
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| Online Access: | https://doi.org/10.1111/1759-7714.15514 |
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| author | Yun Bai Xianshu Gao Shangbin Qin Shanshi Li Mingwei Ma Xi Cao Feng Lyu Jiayan Chen Xin Qi Siwei Liu Yan Gao Hongzhen Li Xiaomei Li Xiaoying Li Xueying Ren Lei Huang |
| author_facet | Yun Bai Xianshu Gao Shangbin Qin Shanshi Li Mingwei Ma Xi Cao Feng Lyu Jiayan Chen Xin Qi Siwei Liu Yan Gao Hongzhen Li Xiaomei Li Xiaoying Li Xueying Ren Lei Huang |
| author_sort | Yun Bai |
| collection | DOAJ |
| description | ABSTRACT Objective Stereotactic ablative radiotherapy (SABR) is renowned for its high local control (LC) rates. Nonetheless, for tumors that are either large in volume or in close proximity to critical organs at risk, the application of SABR to the entire tumor becomes impractical. This study aims to evaluate the efficacy and safety of partial SABR boost before conventional radiotherapy (P‐SABR) for the treatment of large (> 5 cm) unresectable stage III nonsmall cell lung cancer (NSCLC). Methods From April 2014 to January 2024, 44 patients with > 5 cm unresectable T3‐4N0‐3M0 stage III NSCLC were analyzed. The median diameter was 9 cm (5.2–22.7 cm). The P‐SABR plan is combined with a partial SABR boost part and a conventional fractionated radiotherapy (CFRT) part. In the partial SABR boost plan, the prescription dose for planning target volume (PTV) was 1.8–3 Gy per fraction over 3–4 fractions, and the artificially delineated gross tumor boost volume (GTVb) within GTV received a simultaneously integrated SABR dose (6 or 8 Gy per fraction). In the following CFRT plan, the median dose for the entire PTV was 54 Gy in 22 fractions. For the synthetic P‐SABR plan, the median cumulative dose delivered to the PTV was 62.1 Gy, while the median cumulative dose to the GTVb was escalated to 78 Gy. Results The median follow‐up time was 36 months (95% CI, 14.6–57.4 months). The LC rates at 1 and 2 years were 90.2% and 76.8%, respectively. The median OS was 47.0 months (95% CI, 16.8–77.2 months) and 15.0 months (95% CI, 6.0–24.0 months) for the chemoradiotherapy and radiotherapy groups, respectively. Univariate analysis showed that P‐SABR combined with immunotherapy was associated with significantly longer OS (HR, 0.163; 95% CI, 0.038–0.704). Only one (2.3%) patient experienced grade 3 acute pneumonitis. Conclusions The P‐SABR treatment has shown a high rate of LC and tolerable toxicity in patients with large unresectable stage III NSCLC. |
| format | Article |
| id | doaj-art-dbd5ca499a73409e80da056311c4a9af |
| institution | Kabale University |
| issn | 1759-7706 1759-7714 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Thoracic Cancer |
| spelling | doaj-art-dbd5ca499a73409e80da056311c4a9af2025-01-30T22:40:34ZengWileyThoracic Cancer1759-77061759-77142025-01-01162n/an/a10.1111/1759-7714.15514Partial Stereotactic Ablative Radiotherapy Boost Before Conventional Radiotherapy (P‐SABR) for Large (> 5 cm) Unresectable Stage III Nonsmall Cell Lung CancerYun Bai0Xianshu Gao1Shangbin Qin2Shanshi Li3Mingwei Ma4Xi Cao5Feng Lyu6Jiayan Chen7Xin Qi8Siwei Liu9Yan Gao10Hongzhen Li11Xiaomei Li12Xiaoying Li13Xueying Ren14Lei Huang15Department of Radiation Oncology Peking University First Hospital Beijing ChinaDepartment of Radiation Oncology Peking University First Hospital Beijing ChinaDepartment of Radiation Oncology Peking University First Hospital Beijing ChinaDepartment of Radiation Oncology Peking University First Hospital Beijing ChinaDepartment of Radiation Oncology Peking University First Hospital Beijing ChinaDepartment of Radiation Oncology William Beaumont Hospital Oak Michigan USADepartment of Radiation Oncology Peking University First Hospital Beijing ChinaDepartment of Radiation Oncology Peking University First Hospital Beijing ChinaDepartment of Radiation Oncology Peking University First Hospital Beijing ChinaDepartment of Radiation Oncology Peking University First Hospital Beijing ChinaDepartment of Radiation Oncology Peking University First Hospital Beijing ChinaDepartment of Radiation Oncology Peking University First Hospital Beijing ChinaDepartment of Radiation Oncology Peking University First Hospital Beijing ChinaDepartment of Radiation Oncology Peking University First Hospital Beijing ChinaDepartment of Radiation Oncology Peking University First Hospital Beijing ChinaDepartment of Radiation Oncology Peking University First Hospital Beijing ChinaABSTRACT Objective Stereotactic ablative radiotherapy (SABR) is renowned for its high local control (LC) rates. Nonetheless, for tumors that are either large in volume or in close proximity to critical organs at risk, the application of SABR to the entire tumor becomes impractical. This study aims to evaluate the efficacy and safety of partial SABR boost before conventional radiotherapy (P‐SABR) for the treatment of large (> 5 cm) unresectable stage III nonsmall cell lung cancer (NSCLC). Methods From April 2014 to January 2024, 44 patients with > 5 cm unresectable T3‐4N0‐3M0 stage III NSCLC were analyzed. The median diameter was 9 cm (5.2–22.7 cm). The P‐SABR plan is combined with a partial SABR boost part and a conventional fractionated radiotherapy (CFRT) part. In the partial SABR boost plan, the prescription dose for planning target volume (PTV) was 1.8–3 Gy per fraction over 3–4 fractions, and the artificially delineated gross tumor boost volume (GTVb) within GTV received a simultaneously integrated SABR dose (6 or 8 Gy per fraction). In the following CFRT plan, the median dose for the entire PTV was 54 Gy in 22 fractions. For the synthetic P‐SABR plan, the median cumulative dose delivered to the PTV was 62.1 Gy, while the median cumulative dose to the GTVb was escalated to 78 Gy. Results The median follow‐up time was 36 months (95% CI, 14.6–57.4 months). The LC rates at 1 and 2 years were 90.2% and 76.8%, respectively. The median OS was 47.0 months (95% CI, 16.8–77.2 months) and 15.0 months (95% CI, 6.0–24.0 months) for the chemoradiotherapy and radiotherapy groups, respectively. Univariate analysis showed that P‐SABR combined with immunotherapy was associated with significantly longer OS (HR, 0.163; 95% CI, 0.038–0.704). Only one (2.3%) patient experienced grade 3 acute pneumonitis. Conclusions The P‐SABR treatment has shown a high rate of LC and tolerable toxicity in patients with large unresectable stage III NSCLC.https://doi.org/10.1111/1759-7714.15514carcinomaimmunotherapynonsmall cell lungradiosurgery |
| spellingShingle | Yun Bai Xianshu Gao Shangbin Qin Shanshi Li Mingwei Ma Xi Cao Feng Lyu Jiayan Chen Xin Qi Siwei Liu Yan Gao Hongzhen Li Xiaomei Li Xiaoying Li Xueying Ren Lei Huang Partial Stereotactic Ablative Radiotherapy Boost Before Conventional Radiotherapy (P‐SABR) for Large (> 5 cm) Unresectable Stage III Nonsmall Cell Lung Cancer Thoracic Cancer carcinoma immunotherapy nonsmall cell lung radiosurgery |
| title | Partial Stereotactic Ablative Radiotherapy Boost Before Conventional Radiotherapy (P‐SABR) for Large (> 5 cm) Unresectable Stage III Nonsmall Cell Lung Cancer |
| title_full | Partial Stereotactic Ablative Radiotherapy Boost Before Conventional Radiotherapy (P‐SABR) for Large (> 5 cm) Unresectable Stage III Nonsmall Cell Lung Cancer |
| title_fullStr | Partial Stereotactic Ablative Radiotherapy Boost Before Conventional Radiotherapy (P‐SABR) for Large (> 5 cm) Unresectable Stage III Nonsmall Cell Lung Cancer |
| title_full_unstemmed | Partial Stereotactic Ablative Radiotherapy Boost Before Conventional Radiotherapy (P‐SABR) for Large (> 5 cm) Unresectable Stage III Nonsmall Cell Lung Cancer |
| title_short | Partial Stereotactic Ablative Radiotherapy Boost Before Conventional Radiotherapy (P‐SABR) for Large (> 5 cm) Unresectable Stage III Nonsmall Cell Lung Cancer |
| title_sort | partial stereotactic ablative radiotherapy boost before conventional radiotherapy p sabr for large 5 cm unresectable stage iii nonsmall cell lung cancer |
| topic | carcinoma immunotherapy nonsmall cell lung radiosurgery |
| url | https://doi.org/10.1111/1759-7714.15514 |
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