title: Outcomes of stereotactic ablative radiotherapy following a clinical diagnosis of stage I NSCLC: comparison with a contemporaneous cohort with pathologically proven disease.
abstract: BACKGROUND
  As a finding of benign disease is uncommon in Dutch patients undergoing surgery after a clinical diagnosis of stage I NSCLC, patients are also accepted for stereotactic ablative radiotherapy (SABR) without pathology. We studied outcomes in patients who underwent SABR after either a pathological (n=209) or clinical diagnosis (N=382).
  
  
  METHODS
  Five hundred and ninety-one patients with a single pulmonary lesion underwent SABR after either a pathological- or a clinical diagnosis of stage I NSCLC based on a (18)FDG-PET positive lesion with CT features of malignancy. SABR was delivered to a total dose of 60Gy in 3, 5 or 8 fractions, and outcomes were compared between groups with and without pathological diagnosis.
  
  
  RESULTS
  Patients with pathology had significantly larger tumor diameters (p<.001) and higher predicted FEV1% values (p=.025). No significant differences were observed between both groups in overall survival (p=.99) or local control (p=.98). Regional and distant recurrence rates were also similar.
  
  
  CONCLUSIONS
  In a population with a low incidence of benign (18)FDG-PET positive lung nodules, clinical SABR outcomes were similar in large groups of patients with or without pathology. The survival benefits reported after the introduction of SABR are unlikely to be biased by inclusion of benign lesions.
authors: Department of Radiation Oncology, VU University Medical Center, de Boelelaan 1117, Amsterdam, The Netherlands.
authors: Naomi E
authors: NE
authors: Verstegen
authors: Frank J
authors: FJ
authors: Lagerwaard
authors: Cornelis J A
authors: CJ
authors: Haasbeek
authors: Ben J
authors: BJ
authors: Slotman
authors: Suresh
authors: S
authors: Senan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D016009:Chi-Square Distribution; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009426:Netherlands / Q000453:epidemiology; D049268:Positron-Emission Tomography; D016016:Proportional Hazards Models; D019275:Radiopharmaceuticals; D016634:Radiosurgery / Q000379:methods*; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D015996:Survival Rate; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18