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Gregory J. Riely, MD, PhD
Gregory J. Riely, MD, PhD
Posted: Monday, November 18, 2024
After analyzing clinical outcomes of patients with peripheral, early-stage non–small cell lung cancer (NSCLC) who were treated with stereotactic ablative body radiotherapy (SABR), researchers have identified dosimetric variables that may be associated with overall survival, including planning target volume and minimum dose to planning target volume. These results highlight the importance of generating optimal lung SABR plans to improve outcomes, wrote Minal Padden-Modi, MBBS, BSc, of Cambridge University Hospitals NHS Foundation Trust, United Kingdom, and colleagues in BJR Open.
The 89 patients in their retrospective study—about evenly divided by sex, with a median age of 74 years and almost all with T1–T2 tumors—were treated between 2012 and 2016 and followed until January 2021. About 90% underwent 55 Gy in five fractions, and median overall survival was 58.7 months. Neither patient nor tumor variables showed an association with overall survival.
SABR proved to be an effective treatment for this type of NSCLC. The results also suggested that a larger planning target volume may be associated with poorer overall survival, which warrants further investigation, they said. Potentially, the link could be correlated with increased tumor burden and staging. “We also noted that reduced number of fractions tended to be used to treat patients with a larger planning target volume…, [but we] did not observe [a] correlation between R100 and R50, indicating [that] these dosimetric parameters need further investigation,” observed the authors.
Patients who received a higher minimum dose to the planning target volume tended to have better overall survival, and higher dose delivery to 90% of the planning target volume usually resulted in better outcomes, stated Dr. Padden-Modi and co-investigators. “These findings demonstrate the importance of producing optimal coverage in SABR plans to deliver planned dose to improve patients’ survival,” they concluded.
Disclosure: For full disclosures of the study authors, visit academic.oup.com.
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