Research

Stereotactic, single-dose irradiation of stage I non-small cell lung cancer and lung metastases

Peter Fritz¹ , Hans-Jörg Kraus¹ , Werner Mühlnickel¹ , Udo Hammer² , Wolfram Dölken² , Walburga Engel-Riedel³ , Assad Chemaissani³ and Erich Stoelben³

¹  St. Marien-Krankenhaus, (Medical Education Hospital of the University of Marburg), Department of Radiotherapy, D-57072 Siegen, Germany

²  St. Marien-Krankenhaus, (Medical Education Hospital of the University of Marburg), Department of Radiology, D-57072 Siegen, Germany

³  Cologne Metropolitan General Hospital, Clinic for Thoracic Disease, D-51109 Köln, Germany

author email corresponding author email

Radiation Oncology 2006, 1:30doi:10.1186/1748-717X-1-30

Published:	20 August 2006

Abstract

Background

We prospectively reviewed response rates, local control, and side effects after non-fractionated stereotactic high single-dose body radiation therapy for lung tumors.

Methods

Fifty-eight patients underwent radiosurgery involving single-dose irradiation. With 25 patients, 31 metastases in the lungs were irradiated; with each of 33 patients, stage I non-small cell lung cancer (NSCLC) was subject to irradiation. The standard dose prescribed to the isocenter was 30 Gy with an axial safety margin of 10 mm and a longitudinal safety margin of 15 mm. The planning target volume (PTV) was defined using three CT scans with reference to the phases of respiration so that the movement span of the clinical target volume (CTV) was enclosed.

Results

The volume of the metastases (CTV) varied from 2.8 to 55.8 cm³ (median: 6.0 cm³) and the PTV varied from 12.2 to 184.0 cm³ (median: 45.0 cm³). The metastases ranged from 0.7 to 4.5 cm in largest diameter. The volume of the bronchial carcinomas varied from 4.2 to 125.4 cm³(median: 17.5 cm³) and the PTV from 15.6 to 387.3 cm³ (median: 99.8 cm³). The bronchial carcinomas ranged from 1.7 to 10 cm in largest diameter. Follow-up periods varied from 6.8 to 63 months (median: 22 months for metastases and 18 months for NSCLC). Local control was achieved with 94% of NSCLC and 87% of metastases. No serious symptomatic side effects were observed. According to the Kaplan-Meier method the overall survival probability rates of patients with lung metastases were as follows: 1 year: 97%, 2 years: 73%, 3 years: 42%, 4 years: 42%, 5 years: 42% (median survival: 26 months); of those with NSCLC: 1 year: 83%, 2 years: 63%, 3 years: 53%, 4 years: 39%: (median survival: 20.4 months).

Conclusion

Non-fractionated single-dose irradiation of metastases in the lungs or of small, peripheral bronchial carcinomas is an effective and safe form of local treatment and might become a viable alternative to invasive techniques.