In a report online January 31 in Lung Cancer, they note that data published last year (see Reuters Health report of September 22, 2011) showed SBRT to be effective in early non-small cell lung cancer (NSCLC).
In the new study, Dr. Atsuya Takeda from Ofuna Chuo Hospital and colleagues compared SBRT outcomes in 115 patients with pathologically confirmed NSCLC and another 58 whose solitary pulmonary nodules were diagnosed as lung cancer on clinical grounds only.
There were no significant differences between clinically diagnosed patients and the control group in three-year rates of local control (80% and 87%, respectively), regional-free survival (88% and 91%), metastasis-free survival (70% and 74%), progression-free survival (64% and 67%), cause-specific survival (74% and 71%), or overall survival (54% and 57%).
There was no acute toxicity during SBRT. Grade 2 and 3 radiation pneumonitis developed in 12% and 9% of study group patients, respectively, and in 16% and 3% of controls. There was no grade 4 or 5 radiation pneumonitis, nor any other toxicity of grade 3 or above.
"Currently, for operable patients, lobectomy with mediastinal dissection is a standard therapy," Dr. Takeda told Reuters Health by email. "SBRT can be an option for patients who refuse surgery."
"We hope that more discussion on the optimal treatment strategy for inoperable patients with solitary pulmonary nodule will be raised to reach a consensus," Dr. Takeda said.
"We would like to emphasize that a careful attention is necessary in treating histologically unproven patients," Dr. Takeda added. In these circumstances, Dr. Takeda said, "We would like the physicians to consult with experts including (a respiratory physician), thoracic surgeon, diagnostic radiologist, and radiation oncologist. The possibility of malignancy and treatment strategy for such patients should be fully discussed."
By Will Boggs MD
Last Updated: 2012-02-27 16:46:28 -0400 (Reuters Health)
Lung Cancer 2012.
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