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Aghdam N, Lischalk JW, Marin MP, et al. Lobar Gross Endobronchial Disease Predicts for Overall Survival and Grade 5 Pulmonary Toxicity in Medically Inoperable Early Stage Non-Small Cell Lung Cancer Patients Treated With Stereotactic Body Radiation Therapy. Front Oncol. 2021;11:728519doi: 10.3389/fonc.2021.728519.
Aghdam, N., Lischalk, J. W., Marin, M. P., Hall, C., O'Connor, T., Campbell, L., Suy, S., Collins, S. P., Margolis, M., Krochmal, R., Anderson, E., & Collins, B. T. (2021). Lobar Gross Endobronchial Disease Predicts for Overall Survival and Grade 5 Pulmonary Toxicity in Medically Inoperable Early Stage Non-Small Cell Lung Cancer Patients Treated With Stereotactic Body Radiation Therapy. Frontiers in oncology, 11728519. https://doi.org/10.3389/fonc.2021.728519
Aghdam, Nima, et al. "Lobar Gross Endobronchial Disease Predicts for Overall Survival and Grade 5 Pulmonary Toxicity in Medically Inoperable Early Stage Non-Small Cell Lung Cancer Patients Treated With Stereotactic Body Radiation Therapy." Frontiers in oncology vol. 11 (2021): 728519. doi: https://doi.org/10.3389/fonc.2021.728519
Aghdam N, Lischalk JW, Marin MP, Hall C, O'Connor T, Campbell L, Suy S, Collins SP, Margolis M, Krochmal R, Anderson E, Collins BT. Lobar Gross Endobronchial Disease Predicts for Overall Survival and Grade 5 Pulmonary Toxicity in Medically Inoperable Early Stage Non-Small Cell Lung Cancer Patients Treated With Stereotactic Body Radiation Therapy. Front Oncol. 2021 Nov 29;11:728519. doi: 10.3389/fonc.2021.728519. eCollection 2021. PMID: 34912703; PMCID: PMC8667471.
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Front Oncol. 2021 Nov 29;11:728519. doi: 10.3389/fonc.2021.728519. eCollection 2021.

Lobar Gross Endobronchial Disease Predicts for Overall Survival and Grade 5 Pulmonary Toxicity in Medically Inoperable Early Stage Non-Small Cell Lung Cancer Patients Treated With Stereotactic Body Radiation Therapy.

Frontiers in oncology

Nima Aghdam, Jonathan W Lischalk, Monica Pernia Marin, Clare Hall, Timothy O'Connor, Lloyd Campbell, Simeng Suy, Sean P Collins, Marc Margolis, Rebecca Krochmal, Eric Anderson, Brian T Collins

Affiliations

  1. Department of Radiation Oncology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United States.
  2. Department of Radiation Oncology, Perlmutter Cancer Center New York University at Langone Hospital - Long Island, New York, NY, United States.
  3. Geriatrics and Palliative Medicine Division, George Washington University Hospital, Washington, DC, United States.
  4. College of Arts and Sciences, Cornell University, Ithaca, NY, United States.
  5. Georgetown University School of Medicine, Washington, DC, United States.
  6. Department of Radiation Medicine, MedStar Georgetown University Hospital, Washington, DC, United States.
  7. Division of Thoracic Surgery, MedStar Georgetown University Hospital, Washington, DC, United States.
  8. Division of Pulmonary and Critical Care Medicine, MedStar Georgetown University Hospital, Washington, DC, United States.

PMID: 34912703 PMCID: PMC8667471 DOI: 10.3389/fonc.2021.728519

Abstract

PURPOSE: Stereotactic body radiation therapy (SBRT) is considered standard of care for medically inoperable early stage non-small cell lung cancer (ES-NSCLC). Central tumor location is a known risk factor for severe SBRT related toxicity. Bronchoscopy allows for visualization of the central airways prior to treatment. Five fraction SBRT approaches have been advocated to mitigate treatment induced toxicity. In this report, we examine the mature clinical outcomes of a diverse cohort of ES-NSCLC patients with both peripheral and central tumors treated with a conservative 5 fraction SBRT approach and evaluate the role of lobar gross endobronchial disease (LGED) in predicting overall survival and treatment-related death.

METHODS: Medically inoperable biopsy-proven, lymph node-negative ES-NSCLC patients were treated with SBRT. Bronchoscopy was completed prior to treatment in all centrally located cases. The Kaplan-Meier method was used to estimate overall survival (OS), local control (LC), regional control (RC), distant metastasis free survival (DMFS) and disease-free survival (DFS). Overall survival was stratified based on clinical stage, histology, tumor location and LGED. Toxicities were scored according to the National Cancer Institute Common Terminology Criteria for Adverse Events, Version 5.0.

RESULTS: From December 2010 to December 2015, 50 consecutive patients were treated uniformly with a 50 Gy in 5 fraction SBRT approach (tumor BED

CONCLUSIONS: Central location of ES-NSCLC is a well-established predictor for severe SBRT-related toxicity. Here we identify LGED as a significant predictor of poor overall survival and grade 5 pulmonary toxicity. The relatively high rates of severe treatment-related toxicity seen in patients with central ES-NSCLC may be due in part to LGED. Underlying LGED may cause irreparable damage to the lobar airway, unmitigated by SBRT treatment thus increasing the risk of severe treatment-related toxicity. These findings should be verified in larger data sets. Future prospective central ES-NSCLC clinical trials should require staging bronchoscopy to identify LGED and further assess its clinical significance.

Copyright © 2021 Aghdam, Lischalk, Marin, Hall, O’Connor, Campbell, Suy, Collins, Margolis, Krochmal, Anderson and Collins.

Keywords: bronchoscopy; gross endobronchial disease; inoperable; non-small cell lung cancer; stereotactic body radiation therapy

Conflict of interest statement

SC receives research funding from Accuray Inc. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a po

References

  1. J Hematol Oncol. 2010 Feb 04;3:6 - PubMed
  2. Ann Thorac Surg. 2010 Feb;89(2):368-73; discussion 373-4 - PubMed
  3. J Hematol Oncol. 2009 Jan 17;2:1 - PubMed
  4. J Clin Oncol. 2019 May 20;37(15):1316-1325 - PubMed
  5. J Clin Oncol. 2006 Oct 20;24(30):4833-9 - PubMed
  6. Radiat Oncol. 2007 Oct 22;2:39 - PubMed
  7. Front Oncol. 2012 Feb 01;2:9 - PubMed
  8. Chest. 2003 Nov;124(5):1946-55 - PubMed
  9. J Hematol Oncol. 2010 Oct 22;3:39 - PubMed
  10. JAMA. 2010 Mar 17;303(11):1070-6 - PubMed
  11. Int J Radiat Oncol Biol Phys. 2018 Sep 1;102(1):44-52 - PubMed
  12. J Radiosurg SBRT. 2013;2(2):85-98 - PubMed
  13. Lung Cancer. 2018 Apr;118:20-26 - PubMed
  14. Radiother Oncol. 2017 Nov;125(2):317-324 - PubMed
  15. Int J Radiat Oncol Biol Phys. 2005 Nov 15;63(4):1010-5 - PubMed
  16. Radiat Oncol. 2016 Feb 27;11:28 - PubMed
  17. Med Phys. 2010 Aug;37(8):4078-101 - PubMed
  18. Clin Lung Cancer. 2007 Jan;8(4):252-6 - PubMed
  19. Int J Radiat Oncol Biol Phys. 2009 Nov 1;75(3):677-82 - PubMed
  20. J Radiat Oncol. 2016;5(4):379-387 - PubMed

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