title: Stereotactic Body Radiotherapy for Large (> 5 cm) Non-Small-Cell Lung Cancer.
abstract: Stereotactic body radiotherapy (SBRT) is a well-established treatment option for early stage non-small-cell lung cancer (NSCLC) tumors < 5 cm. There is limited information on tumors > 5 cm.
  
  
  
  We performed retrospective data collection of patients enrolled onto a prospective SBRT registry study. Eligible patients for this study had node-negative NSCLC measuring > 5 cm in any dimension. Data from 41 patients were analyzed. Median patient age was 75 years, and median tumor size was 5.6 cm (range, 5.0-12.2 cm). Sixteen patients had squamous disease, 20 patients adenocarcinoma, and 1 mixed tumor; 4 patients had no biopsy. Median radiation dose per fraction was 50 Gy in 5 fractions. Radiation was prescribed to isodose line, median 66% (range, 50%-84%).
  
  
  
  Before SBRT, 6 patients had previous chemotherapy and 7 patients had previous radiation. Median follow-up for all patients was 15.2 months (range, 0.56-48.1 months). At last follow-up, 16 patients were still alive, with a median follow-up of 16.1 months for surviving patients. The median survival was 17.5 months with 1- and 2-year survivals of 65% and 34%. Two patients (4.8%) had local failure, and 13 patients (31%) had distant failure. Four patients (9.8%) had acute toxicity, and 7 patients (17.1%) had late toxicity, including 2 (4.8%) grade 3 late toxicities.
  
  
  
  SBRT for tumors > 5 cm is effective, with good local control rates and acceptable toxicity. The main pattern of failure is distant, suggesting a possible role for systemic chemotherapy in these patients.
authors.affiliation: Rowan Medical School, Camden, NJ.
authors.forename: Justin
authors.initials: J
authors.lastname: Peterson
authors.affiliation: Rowan Medical School, Camden, NJ.
authors.forename: Christian
authors.initials: C
authors.lastname: Niles
authors.affiliation: Department of Radiation Oncology, MD Anderson at Cooper University Hospital, Camden, NJ.
authors.forename: Ashish
authors.initials: A
authors.lastname: Patel
authors.affiliation: Department of Pulmonary Medicine, Cooper University Hospital, Camden, NJ.
authors.forename: Ziad
authors.initials: Z
authors.lastname: Boujaoude
authors.affiliation: Department of Pulmonary Medicine, Cooper University Hospital, Camden, NJ.
authors.forename: Wissam
authors.initials: W
authors.lastname: Abouzgheib
authors.affiliation: Department of Radiation Oncology, MD Anderson at Cooper University Hospital, Camden, NJ.
authors.forename: Ben
authors.initials: B
authors.lastname: Goldsmith
authors.affiliation: Department of Radiation Oncology, MD Anderson at Cooper University Hospital, Camden, NJ.
authors.forename: Sucha
authors.initials: S
authors.lastname: Asbell
authors.affiliation: Department of Radiation Oncology, MD Anderson at Cooper University Hospital, Camden, NJ.
authors.forename: Qianyi
authors.initials: Q
authors.lastname: Xu
authors.affiliation: Department of Medical Oncology, MD Anderson at Cooper University Hospital, Camden, NJ.
authors.forename: Polina
authors.initials: P
authors.lastname: Khrizman
authors.affiliation: Department of Radiation Oncology, MD Anderson at Cooper University Hospital, Camden, NJ. Electronic address: Kubicek-Gregory@cooperhealth.edu.
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Kubicek
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011446:Prospective Studies; D016634:Radiosurgery; D012189:Retrospective Studies; D047368:Tumor Burden
keywords: > 5 cm; Large size; NSCLC; Radiosurgery; SBRT