Local tumor control probability modeling of primary and secondary lung tumors in stereotactic body radiotherapy.

BACKGROUND AND PURPOSE To evaluate whether local tumor control probability (TCP) in stereotactic body radiotherapy (SBRT) varies between lung metastases of different primary cancer sites and between primary non-small cell lung cancer (NSCLC) and secondary lung tumors. MATERIALS AND METHODS A retrospective multi-institutional (n=22) database of 399 patients with stage I NSCLC and 397 patients with 525 lung metastases was analyzed. Irradiation doses were converted to biologically effective doses (BED). Logistic regression was used for local tumor control probability (TCP) modeling and the second-order bias corrected Akaike Information Criterion was used for model comparison. RESULTS After median follow-up of 19 months and 16 months (n.s.), local tumor control was observed in 87.7% and 86.7% of the primary and secondary lung tumors (n.s.), respectively. A strong dose-response relationship was observed in the primary NSCLC and metastatic cohort but dose-response relationships were not significantly different: the TCD90 (dose to achieve 90% TCP; BED of maximum planning target volume dose) estimates were 176 Gy (151-223) and 160 Gy (123-237) (n.s.), respectively. The dose-response relationship was not influenced by the primary cancer site within the metastatic cohort. CONCLUSIONS Dose-response relationships for local tumor control in SBRT were not different between lung metastases of various primary cancer sites and between primary NSCLC and lung metastases.

[1]  Lech Papiez,et al.  Stereotactic body radiation therapy of early-stage non-small-cell lung carcinoma: phase I study. , 2005, International journal of radiation oncology, biology, physics.

[2]  B. Kavanagh,et al.  Stereotactic body radiation therapy for melanoma and renal cell carcinoma: impact of single fraction equivalent dose on local control , 2010, Radiation oncology.

[3]  P. Iyengar,et al.  Phase II trial of stereotactic body radiation therapy combined with erlotinib for patients with limited but progressive metastatic non-small-cell lung cancer. , 2014, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[4]  M. Schell,et al.  A prospective pilot study of curative‐intent stereotactic body radiation therapy in patients with 5 or fewer oligometastatic lesions , 2008, Cancer.

[5]  M. Lodge,et al.  Stereotactic radiotherapy (SABR) for the treatment of primary non-small cell lung cancer; systematic review and comparison with a surgical cohort. , 2013, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[6]  Matthias Guckenberger,et al.  Applicability of the linear-quadratic formalism for modeling local tumor control probability in high dose per fraction stereotactic body radiotherapy for early stage non-small cell lung cancer. , 2013, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[7]  M. Buyse,et al.  RESEKTION VON LUNGENMETASTASEN: LANGZEITRESULTATE PROGNOSTISCHER FAKTOREN AUF DER BASIS VON 5206 FALLEN: THE INTERNATIONAL REGISTRY OF LUNG METASTASES , 1999 .

[8]  P. Franco,et al.  Stereotactic ablative radiation therapy as first local therapy for lung oligometastases from colorectal cancer: a single-institution cohort study. , 2015, International journal of radiation oncology, biology, physics.

[9]  I. Poon,et al.  Predictive factors for local control in primary and metastatic lung tumours after four to five fraction stereotactic ablative body radiotherapy: a single institution's comprehensive experience. , 2014, Clinical oncology (Royal College of Radiologists (Great Britain)).

[10]  E. Kunieda,et al.  Stereotactic body radiotherapy (SBRT) for oligometastatic lung tumors from colorectal cancer and other primary cancers in comparison with primary lung cancer. , 2011, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[11]  L. Woolner,et al.  THE SURGICAL TREATMENT OF METASTATIC TUMORS IN THE LUNGS. , 1965, The Journal of thoracic and cardiovascular surgery.

[12]  L. Gaspar,et al.  Multi-institutional phase I/II trial of stereotactic body radiation therapy for lung metastases. , 2009, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[13]  M. G. Pittau,et al.  A weakly informative default prior distribution for logistic and other regression models , 2008, 0901.4011.

[14]  F. Sterzing,et al.  Safety and Efficacy of Stereotactic Body Radiotherapy for Stage I Non–Small-Cell Lung Cancer in Routine Clinical Practice: A Patterns-of-Care and Outcome Analysis , 2013, Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer.

[15]  R. Weichselbaum,et al.  Stereotactic body radiotherapy for multisite extracranial oligometastases , 2012, Cancer.

[16]  L H Blumgart,et al.  Clinical score for predicting recurrence after hepatic resection for metastatic colorectal cancer: analysis of 1001 consecutive cases. , 1999, Annals of surgery.

[17]  L. Gaspar,et al.  Observation of a dose-control relationship for lung and liver tumors after stereotactic body radiation therapy. , 2009, International journal of radiation oncology, biology, physics.

[18]  Max Dahele,et al.  Management of early-stage non-small cell lung cancer using stereotactic ablative radiotherapy: controversies, insights, and changing horizons. , 2015, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[19]  M. Baumann,et al.  SABR in NSCLC--the beginning of the end or the end of the beginning? , 2015, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[20]  F. Petrella,et al.  A 10-Year Single-Center Experience on 708 Lung Metastasectomies: The Evidence of the “International Registry of Lung Metastases” , 2011, Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer.

[21]  H. Strander,et al.  A retrospective study of SBRT of metastases in patients with primary sarcoma , 2012, Medical Oncology.

[22]  M. Høyer,et al.  Survival and prognostic factors in 321 patients treated with stereotactic body radiotherapy for oligo-metastases. , 2015, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[23]  A. Gelman.  Scaling regression inputs by dividing by two standard deviations , 2008, Statistics in medicine.

[24]  B. Loo,et al.  Colorectal Histology Is Associated With an Increased Risk of Local Failure in Lung Metastases Treated With Stereotactic Ablative Radiation Therapy. , 2015, International journal of radiation oncology, biology, physics.

[25]  Andrew Gelman,et al.  Data Analysis Using Regression and Multilevel/Hierarchical Models , 2006 .

[26]  Matthias Guckenberger,et al.  Dose-response relationship for image-guided stereotactic body radiotherapy of pulmonary tumors: relevance of 4D dose calculation. , 2009, International journal of radiation oncology, biology, physics.

[27]  Thomas Krieger,et al.  Influence of calculation model on dose distribution in stereotactic radiotherapy for pulmonary targets. , 2005, International journal of radiation oncology, biology, physics.