Survey of the Patterns of Using Stereotactic Ablative Radiotherapy for Early-Stage Non-small Cell Lung Cancer in Korea.
OBJECTIVE
Stereotactic ablative radiotherapy (SABR) is an effective emerging technique for early-stage non-small cell lung cancer (NSCLC). We investigated the current practice of SABR for early-stage NSCLC in Korea.


METHODS
We conducted a nationwide survey of SABR for NSCLC by sending e-mails to all board-certified members of the Korean Society for Radiation Oncology. The survey included 23 questions focusing on the technical aspects of SABR and 18 questions seeking the participants' opinions on specific clinical scenarios in the use of SABR for early-stage NSCLC. Overall, 79 radiation oncologists at 61/85 specialist hospitals in Korea (71.8%) responded to the survey.


RESULTS
SABR was used at 33 institutions (54%) to treat NSCLC. Regarding technical aspects, the most common planning methods were the rotational intensity-modulated technique (59%) and the static intensity-modulated technique (49%). Respiratory motion was managed by gating (54%) or abdominal compression (51%), and 86% of the planning scans were obtained using 4-dimensional computed tomography. In the clinical scenarios, the most commonly chosen fractionation schedule for peripherally located T1 NSCLC was 60 Gy in four fractions. For centrally located tumors and T2 NSCLC, the oncologists tended to avoid SABR for radiotherapy, and extended the fractionation schedule.


CONCLUSIONS
The results of our survey indicated that SABR is increasingly being used to treat NSCLC in Korea. However, there were wide variations in the technical protocols and fractionation schedules of SABR for early-stage NSCLC among institutions. Standardization of SABR is necessary before implementing nationwide, multicenter, randomized studies.
Department of Radiation Oncology, Samsung Medical Center, Seoul, Korea.
Sanghyuk
S
Song
Department of Radiation Oncology, SMG-SNU Boramae Medical Center, Seoul, Korea.
Ji Hyun
JH
Chang
Department of Radiation Oncology, Seoul National University Hospital, Seoul, Korea.
Hak Jae
HJ
Kim
Department of Radiation Oncology, Seoul St. Mary's Hospital, Seoul, Korea.
Yeon Sil
YS
Kim
Department of Radiation Oncology, Keimyung University Hospital, Daegu, Korea.
Jin Hee
JH
Kim
Department of Radiation Oncology, Samsung Medical Center, Seoul, Korea.
Yong Chan
YC
Ahn
Department of Radiation Oncology, Seoul National University Bundang Hospital, Seongnam, Korea.
Jae-Sung
JS
Kim
Department of Radiation Oncology, Asan Medical Center, Seoul, Korea.
Si Yeol
SY
Song
Proton Therapy Center, National Cancer Center, Goyang, Korea.
Sung Ho
SH
Moon
Department of Radiation Oncology, Chungnam National University Hospital, Daejeon, Korea.
Moon June
MJ
Cho
Department of Radiation Oncology, Eulji University Hospital, Daejeon, Korea.
Seon Min
SM
Youn
D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis / Q000453:epidemiology* / Q000532:radiotherapy*; D000066491:Clinical Decision-Making; D005500:Follow-Up Studies; D019538:Health Care Surveys; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000532:radiotherapy*; D009367:Neoplasm Staging; D010818:Practice Patterns, Physicians'; D000072378:Radiation Oncologists; D016634:Radiosurgery / Q000379:methods; D056910:Republic of Korea / Q000453:epidemiology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
Clinical practice pattern; Non-small cell lung carcinoma; Stereotactic body radiotherapy; Surveys and questionnaires