title: Use of stereotactic body radiation therapy for medically inoperable multiple primary lung cancer.
abstract: BACKGROUND
  To review outcomes of medically inoperable patients treated with stereotactic body radiation therapy (SBRT) for multiple primary lung cancer (MPLC).
  
  
  METHODS
  We retrospectively reviewed the charts of 10 patients (21 lesions) treated with SBRT for synchronous (seven), metachronous (one) or synchronous/metachronous lung cancers. All patients were male, medically inoperable and had a median age of 66 years. Eight patients had bilateral disease and two had unilateral disease. All patients had a histological diagnosis in at least one of the two lesions and four patients (44.4%) had both lesions biopsied. There were 18 T1 lesions and three T2 lesions. SBRT was in three fractions of 20 Gy or five fractions of 11-12 Gy to each lesion.
  
  
  RESULTS
  Mean and median follow up were 18.8 and 15.5 months, respectively. At analysis, six patients (60.0%) are alive, and five of these living patients (83.3%) have no evidence of disease recurrence or progression. Four patients (44.4%) developed distant metastatic disease. Twenty lesions (95.2%) achieved in-field local control. No patients experienced acute pulmonary complications and only two patients (22.2%) experienced late grade I lung toxicity as per the Radiation Therapy Oncology Group toxicity criteria.
  
  
  CONCLUSIONS
  SBRT for MPLC in medically inoperable patients is a safe, feasible and effective treatment approach.
authors.affiliation: Stephenson Oklahoma Cancer Center, Department of Radiation Oncology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73104, USA. chance-matthiesen@ouhsc.edu
authors.forename: Chance
authors.initials: C
authors.lastname: Matthiesen
authors.forename: J Spencer
authors.initials: JS
authors.lastname: Thompson
authors.forename: Tania
authors.initials: T
authors.lastname: De La Fuente Herman
authors.forename: Salahuddin
authors.initials: S
authors.lastname: Ahmad
authors.forename: Terence
authors.initials: T
authors.lastname: Herman
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy; D016634:Radiosurgery / Q000379:methods*; D016896:Treatment Outcome