Single-fraction SBRT confers ‘surprisingly excellent’ outcomes for central lung tumors
Click Here to Manage Email Alerts
Key takeaways:
- Patients with central lung tumors treated with single-fraction radiation did not experience any grade 3 or higher adverse events.
- The approach resulted in local disease control for most trial participants.
Single-fraction stereotactic body radiation therapy may be an effective treatment for individuals with central lung cancer, according to prospective study results presented at American Society for Radiation Oncology Annual Meeting.
Most patients with non-small cell lung cancer who received the therapy exhibited local disease control, and none experienced any grade 3 or higher adverse events.
“The outcomes were surprisingly excellent,” Anurag K. Singh, MD, professor of oncology and director of radiation research at Roswell Park Comprehensive Cancer Center, told Healio. “The lone failure occurred in a patient who was underdosed per protocol by 40%. No significant toxicities have yet been seen.”
Background and methods
SBRT can be an effective treatment for individuals with peripheral lung malignancies, but it carries a high risk for treatment-related death for patients with centrally located tumors, according to study background.
“There can be significant toxicity when irradiating central lung lesions,” Mark Farrugia, MD, PhD, clinical assistant professor of oncology in the radiation medicine department at Roswell Park Comprehensive Cancer Center, told Healio. “The optimal radiation regimen and method of delivery is an area of active study.”
Researchers conducted a pilot study that included 30 adults (median age, 78.9 years; range, 57-87.7; 56.7% women) diagnosed with NSCLC. All study participants had ECOG performance status between 0 and 2, stage T1-3N0M0 disease, and a tumor within 2 cm of any mediastinal critical structures.
Participants received one 27 Gy dose of SBRT.
Safety served as the primary endpoint. OS and local control served ss secondary endpoints.
Results and next steps
After median follow-up of 12.7 months (range, 2.8-24.6), 97% of patients had achieved local disease control.
Results showed an estimated 1-year OS of 85% (95% CI, 69-93).
All but one adverse event was grade one. One patient developed grade 2 back pain.
Four individuals experienced grade 1 fatigue.
“We wondered whether reducing the radiation dose to the organs at risk — even at the expense of controlling the tumor — would lower the risk [for] toxicity while still achieving acceptable local control,” Singh said in a press release. “Indeed, this appears to be the case.”
More research is needed to determine any late-developing toxicities or treatment-related issues, Farrugia told Healio.
“Single-fraction stereotactic body radiation is a convenient, cost-effective, and potentially safer method of treating central lung cancer,” Farrugia added.
References:
- Malik NK, et al. Abstract 285. Presented at: ASTRO Annual Meeting; Sept. 29-Oct. 2, 2024; Washington, D.C.
- Roswell Park radiation oncologist highlights new insights on single-fraction radiation for central lung tumors (press release). Available at https://www.roswellpark.org/newsroom/202410-roswell-park-radiation-oncologist-highlights-new-insights-single-fraction-radiation. Published Oct. 1, 2024. Accessed Oct. 31, 2024.
For more information:
Mark Farrugia, MD, PhD, can be reached at mark.farrugia@roswellpark.org.
Anurag K. Singh, MD, can be reached at anurag.singh@roswellpark.org.
Collapse
Malik NK, et al. Abstract 285. Presented at: ASTRO Annual Meeting; Sept. 29-Oct. 2, 2024; Washington, D.C.
Click Here to Manage Email Alerts