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Preservation of Pulmonary Function Following Stereotactic Body Radiotherapy for Stage I Non-small Cell Lung Cancer FREE TO VIEW

Mark D. Williams, MD, FCCP; Ronald C. McGarry, MD; Robert Timmerman, MD
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Indiana University, Indianapolis, IN


Chest. 2003;124(4_MeetingAbstracts):196S. doi:10.1378/chest.124.4_MeetingAbstracts.196S
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PURPOSE:  To determine the short-term effects of stereotactic body radiotherapy on pulmonary function in patients with medically unresectable stage 1 non-small cell lung cancer (NSCLC).

METHODS:  We recently completed a phase 1 study of stereotactic body radiotherapy which enrolled patients with medically unresectable stage 1 NSCLC. The dose-limiting toxicity was not reached, but the study was halted at a level of 2000cGy/fraction. Subsequently a phase II study was initiated using 2000cGy/fraction times 3 fractions (6000 cGy total) for patients with medically unresectable stage 1 NSCLC. Baseline pulmonary function tests were performed (FEV1, FVC, DLCOand pO2) at baseline, 6 weeks and then at 3 months.

RESULTS:  At this time a total of 13 patients have completed therapy and the initial 3-month follow-up period. One patient suffered a grade 2 pulmonary toxicity (pneumonitis with < 12% change in pulmonary function), which required hospitalization. Baseline pulmonary function values were: FEV1 1.2 liters, FVC 2.4 liters, DLCO 12.4 and pO2 74. At 6 weeks values were: FEV1 1.2, FVC 2.5, DLCO 10.9 and pO2 73. At 3 months post radiotherapy values were: FEV1 1.1, FVC 2.3, DLCO 10.2 and pO2 72. There was no significant decrease in FEV1, FVC or p02, but the DLCO decreased by 18% at 3 months.CONCLUSIONS: In this population of patients with poor pulmonary function, high dose stereotactic body radiotherapy for medically unresectable stage 1 NSCLC did not decrease short-term spirometry or pO2. There was evidence of a decrease in DLCO at 6 weeks and 3 months.

CLINICAL IMPLICATIONS:  Frail patients with medically unresectable stage 1 NSCLC appear to tolerate high doses of targeted radiotherapy. Further study of pulmonary function long-term is required in this population.

DISCLOSURE:  M.D. Williams, None.

Wednesday, October 29, 2003

12:30 PM - 2:00 PM




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