title: Stereotactic body radiation therapy for stage I non-small cell lung cancer: a small academic hospital experience.
abstract: OBJECTIVE
  Stereotactic body radiation therapy (SBRT) has been shown to have increased local control and overall survival relative to conventional external beam radiation therapy in patients with medically inoperable stage I non-small cell lung cancer (NSCLC). Excellent rates of local control have been demonstrated both in clinical trials and in single-center studies at large academic institutions. However, there is limited data on the experiences of small academic hospitals with SBRT for stage I NSCLC. The purpose of this study is to report the local control and overall survival rates in patients treated with SBRT for stage I NSCLC at Winthrop-University Hospital (WUH), a small academic hospital.
  
  
  METHODS
  This is a retrospective review of 78 stage I central and peripheral NSCLC tumors treated between December 2006 and July 2012 with SBRT at WUH. Treatment was given utilizing fiducials and a respiratory tracking system. If the fiducials were not trackable, a spine tracking system was used for tumor localization. CT-based planning was performed using the ray trace algorithm. Treatment was delivered over consecutive days to a median dose of 4800 cGy delivered in four fractions. The Kaplan-Meier method was used to calculate local control and overall survival.
  
  
  RESULTS
  The median age was 78.5 years. Fifty-four percent of the patient population was female. Sixty seven percent of the tumors were stage IA, and 33% of the tumors were stage IB. Fifty-three percent of the tumors were adenocarcinomas and 29% were squamous cell carcinomas, with the remainder being of unknown histology or NSCLC, not otherwise specified The 2-year local control rate was 87%, and the 2-year overall survival was 68%.
  
  
  CONCLUSIONS
  Our findings support that local control and overall survival at a small academic hospital are comparable to that of larger academic institutions' published experiences with SBRT for stage I NSCLC.
authors.affiliation: Division of Radiation Oncology, Winthrop-University Hospital , New York, NY , USA ; Stony Brook School of Medicine , New York, NY , USA.
authors.forename: Oren B
authors.initials: OB
authors.lastname: Factor
authors.affiliation: Stony Brook School of Medicine , New York, NY , USA.
authors.forename: Charles C
authors.initials: CC
authors.lastname: Vu
authors.affiliation: Division of Medical Oncology, Winthrop-University Hospital , New York, NY , USA.
authors.forename: Jeffrey G
authors.initials: JG
authors.lastname: Schneider
authors.affiliation: Division of Radiation Oncology, Winthrop-University Hospital , New York, NY , USA.
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Witten
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Winthrop-University Hospital , New York, NY , USA.
authors.forename: Scott L
authors.initials: SL
authors.lastname: Schubach
authors.affiliation: Division of Radiation Oncology, Winthrop-University Hospital , New York, NY , USA.
authors.forename: Alicia E
authors.initials: AE
authors.lastname: Gittleman
authors.affiliation: Division of Radiation Oncology, Winthrop-University Hospital , New York, NY , USA.
authors.forename: Donna T
authors.initials: DT
authors.lastname: Catell
authors.affiliation: Division of Radiation Oncology, Winthrop-University Hospital , New York, NY , USA.
authors.forename: Jonathan A
authors.initials: JA
authors.lastname: Haas
keywords: CyberKnife; SABR; SBRT; local control; non-small cell lung cancer; overall survival