Stereotactic body radiotherapy to treat small lung lesions clinically diagnosed as primary lung cancer by radiological examination

A prospective observational study

Tetsuya Inoue, Norio Katoh, Yoichi M. Ito, Tomoki Kimura, Yasushi Nagata, Kengo Kuriyama, Hiroshi Onishi, Tadamasa Yoshitake, Yoshiyuki Shioyama, Yusuke Iizuka, Koji Inaba, Koji Konishi, Masaki Kokubo, Katsuyuki Karasawa, Takuyo Kozuka, Kensuke Tanaka, Jun Sakakibara-Konishi, Ichiro Kinoshita, Hiroki Shirato

研究成果: ジャーナルへの寄稿記事

抄録

Objectives: Even with advanced image guidance, biopsies occasionally fail to diagnose small lung lesions, which are highly suggestive of primary lung cancer by radiological examination. The aim of this study was to evaluate the outcome of stereotactic body radiotherapy (SBRT) to treat small lung lesions clinically diagnosed as primary lung cancer. Materials and methods: This is a prospective, multi-institutional observation study. Strict inclusion and exclusion criteria were determined in a nation-wide consensus meeting and used to include patients who were clinically diagnosed with primary lung cancer using precise imaging modalities, for whom further surgical intervention was not feasible, who refused watchful waiting, and who were highly tolerable of SBRT with informed consent. SBRT was performed with 48 Gy in 4 fractions at the tumor isocenter. Results: From August 2009 to August 2014, 62 patients from 11 institutions were enrolled. Their median age was 80 years. The tumors ranged in size from 9 to 30 mm in diameter (median, 18 mm). The median follow-up interval was 55 months. The 3-year overall survival rate was 83.3% (95% confidence interval (CI) 71.1–90.7%) for all the patients and 94.7% (95% CI 68.1–99.2%) for the patients younger than 75 years. Local failure, regional lymph node metastases and distant metastases occurred in 4 (6.4%), 3 (4.8%) and 11 (17.7%) patients, respectively. Grades 3 and 4 toxicities were observed in 8 (12.9%) patients and 1 (1.6%) patient, respectively. No grade 5 toxicities were observed. Conclusions: SBRT is safe and effective for patients with small lung lesions clinically diagnosed as primary lung cancer that satisfied the proposed strict indication criteria as previously reported. A prospective interventional study is required to ascertain if SBRT is an alternative strategy for these patients.

元の言語英語
ページ(範囲)107-112
ページ数6
ジャーナルLung Cancer
122
DOI
出版物ステータス出版済み - 8 1 2018

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Radiosurgery
Observational Studies
Lung Neoplasms
Prospective Studies
Lung
Confidence Intervals
Watchful Waiting
Neoplasm Metastasis
Informed Consent
Neoplasms
Survival Rate
Lymph Nodes
Observation
Biopsy

All Science Journal Classification (ASJC) codes

  • Oncology
  • Pulmonary and Respiratory Medicine
  • Cancer Research

これを引用

Stereotactic body radiotherapy to treat small lung lesions clinically diagnosed as primary lung cancer by radiological examination : A prospective observational study. / Inoue, Tetsuya; Katoh, Norio; Ito, Yoichi M.; Kimura, Tomoki; Nagata, Yasushi; Kuriyama, Kengo; Onishi, Hiroshi; Yoshitake, Tadamasa; Shioyama, Yoshiyuki; Iizuka, Yusuke; Inaba, Koji; Konishi, Koji; Kokubo, Masaki; Karasawa, Katsuyuki; Kozuka, Takuyo; Tanaka, Kensuke; Sakakibara-Konishi, Jun; Kinoshita, Ichiro; Shirato, Hiroki.

:: Lung Cancer, 巻 122, 01.08.2018, p. 107-112.

研究成果: ジャーナルへの寄稿記事

Inoue, T, Katoh, N, Ito, YM, Kimura, T, Nagata, Y, Kuriyama, K, Onishi, H, Yoshitake, T, Shioyama, Y, Iizuka, Y, Inaba, K, Konishi, K, Kokubo, M, Karasawa, K, Kozuka, T, Tanaka, K, Sakakibara-Konishi, J, Kinoshita, I & Shirato, H 2018, 'Stereotactic body radiotherapy to treat small lung lesions clinically diagnosed as primary lung cancer by radiological examination: A prospective observational study', Lung Cancer, 巻. 122, pp. 107-112. https://doi.org/10.1016/j.lungcan.2018.05.025
Inoue, Tetsuya ; Katoh, Norio ; Ito, Yoichi M. ; Kimura, Tomoki ; Nagata, Yasushi ; Kuriyama, Kengo ; Onishi, Hiroshi ; Yoshitake, Tadamasa ; Shioyama, Yoshiyuki ; Iizuka, Yusuke ; Inaba, Koji ; Konishi, Koji ; Kokubo, Masaki ; Karasawa, Katsuyuki ; Kozuka, Takuyo ; Tanaka, Kensuke ; Sakakibara-Konishi, Jun ; Kinoshita, Ichiro ; Shirato, Hiroki. / Stereotactic body radiotherapy to treat small lung lesions clinically diagnosed as primary lung cancer by radiological examination : A prospective observational study. :: Lung Cancer. 2018 ; 巻 122. pp. 107-112.
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abstract = "Objectives: Even with advanced image guidance, biopsies occasionally fail to diagnose small lung lesions, which are highly suggestive of primary lung cancer by radiological examination. The aim of this study was to evaluate the outcome of stereotactic body radiotherapy (SBRT) to treat small lung lesions clinically diagnosed as primary lung cancer. Materials and methods: This is a prospective, multi-institutional observation study. Strict inclusion and exclusion criteria were determined in a nation-wide consensus meeting and used to include patients who were clinically diagnosed with primary lung cancer using precise imaging modalities, for whom further surgical intervention was not feasible, who refused watchful waiting, and who were highly tolerable of SBRT with informed consent. SBRT was performed with 48 Gy in 4 fractions at the tumor isocenter. Results: From August 2009 to August 2014, 62 patients from 11 institutions were enrolled. Their median age was 80 years. The tumors ranged in size from 9 to 30 mm in diameter (median, 18 mm). The median follow-up interval was 55 months. The 3-year overall survival rate was 83.3{\%} (95{\%} confidence interval (CI) 71.1–90.7{\%}) for all the patients and 94.7{\%} (95{\%} CI 68.1–99.2{\%}) for the patients younger than 75 years. Local failure, regional lymph node metastases and distant metastases occurred in 4 (6.4{\%}), 3 (4.8{\%}) and 11 (17.7{\%}) patients, respectively. Grades 3 and 4 toxicities were observed in 8 (12.9{\%}) patients and 1 (1.6{\%}) patient, respectively. No grade 5 toxicities were observed. Conclusions: SBRT is safe and effective for patients with small lung lesions clinically diagnosed as primary lung cancer that satisfied the proposed strict indication criteria as previously reported. A prospective interventional study is required to ascertain if SBRT is an alternative strategy for these patients.",
author = "Tetsuya Inoue and Norio Katoh and Ito, {Yoichi M.} and Tomoki Kimura and Yasushi Nagata and Kengo Kuriyama and Hiroshi Onishi and Tadamasa Yoshitake and Yoshiyuki Shioyama and Yusuke Iizuka and Koji Inaba and Koji Konishi and Masaki Kokubo and Katsuyuki Karasawa and Takuyo Kozuka and Kensuke Tanaka and Jun Sakakibara-Konishi and Ichiro Kinoshita and Hiroki Shirato",
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T1 - Stereotactic body radiotherapy to treat small lung lesions clinically diagnosed as primary lung cancer by radiological examination

T2 - A prospective observational study

AU - Inoue, Tetsuya

AU - Katoh, Norio

AU - Ito, Yoichi M.

AU - Kimura, Tomoki

AU - Nagata, Yasushi

AU - Kuriyama, Kengo

AU - Onishi, Hiroshi

AU - Yoshitake, Tadamasa

AU - Shioyama, Yoshiyuki

AU - Iizuka, Yusuke

AU - Inaba, Koji

AU - Konishi, Koji

AU - Kokubo, Masaki

AU - Karasawa, Katsuyuki

AU - Kozuka, Takuyo

AU - Tanaka, Kensuke

AU - Sakakibara-Konishi, Jun

AU - Kinoshita, Ichiro

AU - Shirato, Hiroki

PY - 2018/8/1

Y1 - 2018/8/1

N2 - Objectives: Even with advanced image guidance, biopsies occasionally fail to diagnose small lung lesions, which are highly suggestive of primary lung cancer by radiological examination. The aim of this study was to evaluate the outcome of stereotactic body radiotherapy (SBRT) to treat small lung lesions clinically diagnosed as primary lung cancer. Materials and methods: This is a prospective, multi-institutional observation study. Strict inclusion and exclusion criteria were determined in a nation-wide consensus meeting and used to include patients who were clinically diagnosed with primary lung cancer using precise imaging modalities, for whom further surgical intervention was not feasible, who refused watchful waiting, and who were highly tolerable of SBRT with informed consent. SBRT was performed with 48 Gy in 4 fractions at the tumor isocenter. Results: From August 2009 to August 2014, 62 patients from 11 institutions were enrolled. Their median age was 80 years. The tumors ranged in size from 9 to 30 mm in diameter (median, 18 mm). The median follow-up interval was 55 months. The 3-year overall survival rate was 83.3% (95% confidence interval (CI) 71.1–90.7%) for all the patients and 94.7% (95% CI 68.1–99.2%) for the patients younger than 75 years. Local failure, regional lymph node metastases and distant metastases occurred in 4 (6.4%), 3 (4.8%) and 11 (17.7%) patients, respectively. Grades 3 and 4 toxicities were observed in 8 (12.9%) patients and 1 (1.6%) patient, respectively. No grade 5 toxicities were observed. Conclusions: SBRT is safe and effective for patients with small lung lesions clinically diagnosed as primary lung cancer that satisfied the proposed strict indication criteria as previously reported. A prospective interventional study is required to ascertain if SBRT is an alternative strategy for these patients.

AB - Objectives: Even with advanced image guidance, biopsies occasionally fail to diagnose small lung lesions, which are highly suggestive of primary lung cancer by radiological examination. The aim of this study was to evaluate the outcome of stereotactic body radiotherapy (SBRT) to treat small lung lesions clinically diagnosed as primary lung cancer. Materials and methods: This is a prospective, multi-institutional observation study. Strict inclusion and exclusion criteria were determined in a nation-wide consensus meeting and used to include patients who were clinically diagnosed with primary lung cancer using precise imaging modalities, for whom further surgical intervention was not feasible, who refused watchful waiting, and who were highly tolerable of SBRT with informed consent. SBRT was performed with 48 Gy in 4 fractions at the tumor isocenter. Results: From August 2009 to August 2014, 62 patients from 11 institutions were enrolled. Their median age was 80 years. The tumors ranged in size from 9 to 30 mm in diameter (median, 18 mm). The median follow-up interval was 55 months. The 3-year overall survival rate was 83.3% (95% confidence interval (CI) 71.1–90.7%) for all the patients and 94.7% (95% CI 68.1–99.2%) for the patients younger than 75 years. Local failure, regional lymph node metastases and distant metastases occurred in 4 (6.4%), 3 (4.8%) and 11 (17.7%) patients, respectively. Grades 3 and 4 toxicities were observed in 8 (12.9%) patients and 1 (1.6%) patient, respectively. No grade 5 toxicities were observed. Conclusions: SBRT is safe and effective for patients with small lung lesions clinically diagnosed as primary lung cancer that satisfied the proposed strict indication criteria as previously reported. A prospective interventional study is required to ascertain if SBRT is an alternative strategy for these patients.

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