Stereotactic body radiation therapy for stage I non-small cell lung cancer patients with chronic respiratory insufficiency requiring domiciliary oxygen therapy

Background: The efficacy of stereotactic body radiation therapy (SBRT) for patients treated with domiciliary oxygen therapy is not well-known. Patients and Methods: We collected the clinical records of 15 patients with chronic respiratory insufficiency requiring domiciliary oxygen therapy at 1-3 l/min who were treated with SBRT for stage I non-small cell lung cancer. All patients were fixed with a thermoplastic body cast system. SBRT was given in 7-8 fields with an isocenter dose of 40-60 Gy in 4-10 fractions (median, 48 Gy in 4 fractions). Results: The overall 2-year and 5-year survival rates for all patients were 67.4% and 34.7%, while the disease-specific 2-year and 5-year survival rates were 90.0% and 72.0%, respectively. Pulmonary adverse effects were mild in the majority of the patients, although two patients had grade 2 radiation pneumonitis. The oxygen flow required increased slightly at follow-up periods greater than one year, but was still at an acceptable level. Conclusion: SBRT was feasible for patients requiring domiciliary oxygen therapy.