Stereotactic body radiation therapy for T 1 N

Stereotactic body radiation therapy for T 1 N 0 M 0 non-small cell lung cancer. First report for inoperable population of a phase II trial by Japan Clinical Oncology Group (JCOG-0403) Y. Nagata*, 　M. Hiraoka#, T. Shibata, H. Onishi, M. Kokubo, K. Karasawa, Y. Shioyama, R. Onimaru, E. Kunieda, S. Ishikura Radiation Therapy Study Group of Japan Clinical Oncology Group *Study Coordinator, #Primary Investigator ASTRO, Boston, Oct. 28 -31, 2012.

• Stereotactic body radiation therapy (SBRT) delivers very targeted beams of radiation to a small area over a few days • SBRT is less invasive than surgery • SBRT is considered to work against T 1 N 0 M 0 lung cancers • First report for operable population was presented in ASTRO 2010. • This presentation is the first report for inoperable population.

• First clinical trial to study SBRT for both inoperable & operable stage IA lung cancers • From 2004 to 2008, 104 patients from 15 institutions with early-stage inoperable nonsmall cell lung cancer were studied • Patients underwent 4 times daily radiotherapy over the course of four to eight days • Each treatment is non-invasive and painless, much like receiving an X-ray

• Patients followed for almost three years (37 months) after treatment • Overall survival rate for patients three years after SBRT was 60 percent • Patients reported only mild side effects from the treatment • Patients with inoperable early lung cancer should consider this treatment

Conv RT vs. SBRT Author Number Morita 149 Dose (med) / 3 -y OS 5 -y OS Daily dose Age Stage 50 -89 I 55 -75 (64. 7)/ 2 Gy 50 -80 (64)/ 1. 8 -3. 0 Gy: QD 39(2 -y) 1. 21. 6 Gy: BID 34. 2 Sibley 141 46 -95 I Krol 108 56 -88 I 60 -65/ 2. 5 -3 Gy 31 This study 104 78 (5990) IA 48/12 Gy 59. 9* Year 22. 2 1980 -1989 13 1980 -1995 15 1978 -1992 40. 8* 2004 -2008 * In all eligible patients (n=100)