Stereotactic body radiation therapy for early stage XXXX : results of a prospective trial.

@entity1 @entity137 @entity1353 @entity5 @entity1149 @entity158 @entity204
@entity1 affected with early stage (IA-IB) @entity1149 ( @entity1149 ), deemed medically inoperable, are usually treated by conventional 3D-CRT, with poor results in terms of @entity5 control and survival. Hypofractionated stereotactic body radiation therapy (SBRT) appears to be a valid alternative option, with high rates of local control and promising survival rates according to recent reported series. We herein report the final results of a prospective phase II trial of SBRT in 62 stage I @entity1149 @entity1 , homogeneously treated with three fractions of 15Gy each, given every other day during a 1 week time, up to a total dose of 45Gy; dose was prescribed to the 80%-isodose encompassing planning target volume. @entity1 were immobilized in a dedicated stereotactic body frame; margins around gross @entity5 volume were 5mm in the axial plane and 10mm in the longitudinal direction. Median age was 73.7 years. A pathologic confirmation of @entity1149 was obtained in 64.5% of @entity1 . Forty-three @entity1 had stage IA and 19 stage IB disease. The majority of @entity1 did not experience any @entity137 ; mild skin reactions, fatigue, @entity1353 /cough or transient @entity158 were recorded in approximately 10% of @entity1 . With a median follow-up time of 28 months, 2 @entity1 experienced an isolated local relapse, 4 an isolated nodal relapse and 15 a systemic failure. At 3 years, local control rate was 87.8%, @entity5 .5%, overall survival 57.1%, with 8 out of 20 non- @entity5 related @entity204 . In multivariate analysis, @entity5 volume was associated with a better outcome. In our series, SBRT was well tolerated and confirmed its efficacy, with local control and survival rates globally superior to those reported using conventional radiotherapy. A longer follow-up is needed in order to establish a correct comparison with surgical series, and to fully ascertain a potential negative impact of SBRT on comorbidities of such a fragile @entity1 population.
