Baseline Pulmonary Function as a Predictor for Survival and Decline in Pulmonary Function Over Time in Patients Undergoing Stereotactic Body Radiotherapy for the Treatment of Stage I Non-Small-Cell Lung Cancer

Mark Henderson, Ronald McGarry, Constantin Yiannoutsos, Achilles Fakiris, David Hoopes, Mark Williams, Robert Timmerman

Research output: Contribution to journalArticle

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Abstract

Purpose: To examine the effect of baseline forced expiratory volume in 1 second (FEV1) and diffusion capacity for carbon monoxide (Dlco) on posttreatment survival and pulmonary function decrease after stereotactic body radiotherapy (SBRT) for patients with early-stage non-small-cell lung cancer (NSCLC). Methods and Materials: Seventy medically inoperable patients with Stage I NSCLC were treated with definitive SBRT to a dose of 6,000 (Stage IA) or 6,600 cGy (Stage IB), given in three equal fractions. Baseline and serial posttreatment pulmonary function data were collected. Results: Median age was 70.5 years, and median follow-up was 2.17 years. Median pretreatment FEV1 and Dlco were 1.05 L and 10.06 mg/min/mm Hg, respectively. There was no significant decrease in survival in patients with baseline FEV1 and Dlco less than the median value and less than the lowest quartile, whereas patients with values greater than the highest quartile of baseline FEV1 had significantly inferior survival. There was no significant effect of pretreatment FEV1 or Dlco on posttreatment levels. There was a statistically significant decrease in Dlco of 1.11 mg/min/mm Hg/y. Conclusions: Poor baseline pulmonary function did not predict decreased survival or pulmonary function after treatment. A statistically significant decrease in Dlco after treatment was seen, similar to decreases seen in studies delivering standard thoracic radiotherapy. We conclude that low pretreatment FEV1 and/or Dlco alone should not be used to exclude patients with NSCLC from treatment with SBRT.

Original languageEnglish (US)
Pages (from-to)404-409
Number of pages6
JournalInternational Journal of Radiation Oncology Biology Physics
Volume72
Issue number2
DOIs
StatePublished - Oct 1 2008

Fingerprint

pulmonary functions
Radiosurgery
Forced Expiratory Volume
Non-Small Cell Lung Carcinoma
lungs
radiation therapy
cancer
Lung
Survival
predictions
quartiles
pretreatment
Therapeutics
Carbon Monoxide
carbon monoxide
Radiotherapy
Thorax
dosage

Keywords

  • Non-small-cell lung cancer
  • Pulmonary function
  • Stereotactic body radiotherapy
  • Toxicity

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation

Cite this

Baseline Pulmonary Function as a Predictor for Survival and Decline in Pulmonary Function Over Time in Patients Undergoing Stereotactic Body Radiotherapy for the Treatment of Stage I Non-Small-Cell Lung Cancer. / Henderson, Mark; McGarry, Ronald; Yiannoutsos, Constantin; Fakiris, Achilles; Hoopes, David; Williams, Mark; Timmerman, Robert.

In: International Journal of Radiation Oncology Biology Physics, Vol. 72, No. 2, 01.10.2008, p. 404-409.

Research output: Contribution to journalArticle

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abstract = "Purpose: To examine the effect of baseline forced expiratory volume in 1 second (FEV1) and diffusion capacity for carbon monoxide (Dlco) on posttreatment survival and pulmonary function decrease after stereotactic body radiotherapy (SBRT) for patients with early-stage non-small-cell lung cancer (NSCLC). Methods and Materials: Seventy medically inoperable patients with Stage I NSCLC were treated with definitive SBRT to a dose of 6,000 (Stage IA) or 6,600 cGy (Stage IB), given in three equal fractions. Baseline and serial posttreatment pulmonary function data were collected. Results: Median age was 70.5 years, and median follow-up was 2.17 years. Median pretreatment FEV1 and Dlco were 1.05 L and 10.06 mg/min/mm Hg, respectively. There was no significant decrease in survival in patients with baseline FEV1 and Dlco less than the median value and less than the lowest quartile, whereas patients with values greater than the highest quartile of baseline FEV1 had significantly inferior survival. There was no significant effect of pretreatment FEV1 or Dlco on posttreatment levels. There was a statistically significant decrease in Dlco of 1.11 mg/min/mm Hg/y. Conclusions: Poor baseline pulmonary function did not predict decreased survival or pulmonary function after treatment. A statistically significant decrease in Dlco after treatment was seen, similar to decreases seen in studies delivering standard thoracic radiotherapy. We conclude that low pretreatment FEV1 and/or Dlco alone should not be used to exclude patients with NSCLC from treatment with SBRT.",
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