Back to Journals » Lung Cancer: Targets and Therapy » Volume 10

Outcomes Following Stereotactic Body Radiotherapy with Intensity-Modulated Therapy versus Three-Dimensional Conformal Radiotherapy in Early Stage Non-Small Cell Lung Cancer

Authors Mix M, Tanny S, Nsouli T, Alden R, Chaudhari R, Kincaid R, Rosenbaum PF, Bogart JA, Aridgides P

Received 23 October 2019

Accepted for publication 29 November 2019

Published 20 December 2019 Volume 2019:10 Pages 151—159


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Dr Sai-Hong Ignatius Ou

Michael Mix,1 Sean Tanny,1 Tamara Nsouli,1 Ryan Alden,1 Rishabh Chaudhari,2 Russell Kincaid,1 Paula F Rosenbaum,3 Jeffrey A Bogart,1 Paul Aridgides1

1Department of Radiation Oncology, SUNY Upstate Medical University, Syracuse, NY 13210, USA; 2Department of Radiation Oncology, University of Cincinnati/University Hospital Barrett Cancer Center, Cincinatti, OH 45267, USA; 3Department of Public Health and Preventive Medicine, SUNY Upstate Medical University, Syracuse, NY, 13210, USA

Correspondence: Michael Mix
Department of Radiation Oncology, SUNY Upstate Medical University, 750 E Adams St, Syracuse, NY 13210, USA
Tel +1 315 464-5276

Introduction: The treatment techniques used for stereotactic body radiation therapy (SBRT) for early-stage lung cancer continue to evolve. In this study, clinical outcomes following SBRT were evaluated according to the use of either 3D conformal radiotherapy (3DCRT) or intensity-modulated radiation therapy (IMRT).
Patients and methods: Patients with stage I NSCLC who received SBRT from 2007 to 2015 were retrospectively reviewed. Disease control and survival were assessed using Kaplan-Meier estimates. Dosimetric analyses for target dose heterogeneity and coverage were performed.
Results: A total of 297 patients with 351 lesions were included. 3DCRT was used in 52% and IMRT in 48%. IMRT was utilized at a higher rate in more recent years. The most common regimens were 48 Gy in 4 fractions and 54–60 Gy in 3 fractions. With a median follow up of 22.7 months, there were 17 local failures for a crude relapse rate of 5.7%. Local failure did not differ in patients treated with 3DCRT and IMRT (4.9% vs 6.5%, p=0.573). Mean dose to gross tumor volume (GTV) as a percent of prescription dose was higher with 3DCRT compared with IMRT (107.7% vs 103.6%, p < 0.0001). Tumor stage, histology, and SBRT regimen did not correlate with local tumor control. Overall survival for the entire population approximated 72% at 2 years. Treatment was well tolerated with 6 documented grade 3+ events.
Conclusion: In this single-institution cohort of SBRT for early-stage NSCLC, there was no discernible difference in clinical outcomes between those treated with 3DCRT and IMRT.

Keywords: SBRT, IMRT, stereotactic ablative radiation therapy, SABR, radiotherapy

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]