title: Image-guided hypofractionated small volume radiotherapy of non-small cell lung cancer - feasibility and clinical outcome.
abstract: OBJECTIVE
  Local hypofractionated stereotactic radiation treatment (hfSRT) of early stage non-small cell lung cancer (NSCLC) represents a highly effective treatment alternative in medically inoperable patients.
  
  
  METHODS
  Between June 2007 and December 2010, 65 patients with NSCLC were treated with image-guided hypofractionated radiotherapy. The Union Internationale Contre le Cancer (UICC) stage distribution was: IA, n = 19; IB, n = 15; IIB, n = 5; IIIA, n = 10; IIIB, n = 6; and IV, n = 10. The fractionation schedule used was 3 × 12.5 Gy (n = 36) prescribed to the encompassing 67% isodose line for peripheral primary tumours, and 8 × 6 Gy (n = 26) or 8 × 5 Gy (n = 3) prescribed to the encompassing 80% isodose line for centrally located tumours.
  
  
  RESULTS
  Mean follow-up was 13.8 months (range 1-41 months). Until now 6 patients developed a local recurrence, 2 of them in combination with mediastinal lymph node failure. The 1-year actuarial local control rate was 93% and overall survival 79%. Pneumonitis was seen in 14 patients (21.5%) (Common Terminology Criteria for Adverse Events (CTCAE) grade I: n = 12, and II: n = 2) after a median time period of 9.5 months. No patient developed pneumonitis of CTCAE grade III or higher.
  
  
  CONCLUSIONS
  Image-guided hfSRT is effective and feasible in patients with non-operable NSCLC, even in higher stages, whenever local control is crucial and there are contraindications against systemic therapy.
authors: Department of Radiation Oncology, Medical School Hannover, Germany.
authors: Stefan
authors: S
authors: Janssen
authors: Nicolas J
authors: NJ
authors: Dickgreber
authors: Carolin
authors: C
authors: Koenig
authors: Michael
authors: M
authors: Bremer
authors: Martin
authors: M
authors: Werner
authors: Johann H
authors: JH
authors: Karstens
authors: Tobias
authors: T
authors: Welte
authors: Andreas
authors: A
authors: Meyer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis / Q000401:mortality* / Q000532:radiotherapy*; D019583:Dose Fractionation, Radiation; D005240:Feasibility Studies; D005260:Female; D005858:Germany; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000401:mortality* / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D020266:Radiotherapy, Conformal / Q000401:mortality*; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome