RESUMO

OBJECTIVES: Stereotactic body radiotherapy (SBRT) is a consolidate treatment for inoperable early-stage lung tumors, usually delivered in single or multi-fraction regimens. We aimed to compare these two approaches in terms of local effectiveness, safety and survival. MATERIALS AND METHODS: Patients affected by medically inoperable early-stage lung tumor were treated at two Institutions with two different schedules: 70 Gy in ten fractions (TF) (BED10: 119 Gy) or 30 Gy in single fraction (SF) (BED10: 120 Gy). RESULTS: 73 patients were treated with SBRT delivered with two biological equivalent schedules: SF (44) and TF (29). The median follow-up was 34 months (range 3-81 months). Three-year Overall survival (OS) was 57.9%, 3-year cancer-specific survival (CSS) was 77.2%, with no difference between treatment groups. Three-year progression-free survival (LPFS) was 88.9% and did not differs between SF and TF. Overall, four cases (5.4%) of acute grade ≥ 3 pneumonitis occurred. No differences in acute and late toxicity between the two groups were detected. CONCLUSION: SF and TF seems to be equally safe and effective in the treatment of primary inoperable lung tumors especially for smaller lesion. The SF may be preferentially offered to reduce patient access to hospital with no negative impact on tumor control and survival.

Assuntos

Neoplasias Pulmonares/mortalidade , Neoplasias Pulmonares/radioterapia , Radiocirurgia/métodos , Idoso , Idoso de 80 Anos ou mais , Fracionamento da Dose de Radiação , Esofagite/epidemiologia , Feminino , Seguimentos , Humanos , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Intervalo Livre de Progressão , Pneumonite por Radiação/epidemiologia , Radiocirurgia/efeitos adversos , Radiocirurgia/mortalidade , Dosagem Radioterapêutica , Fatores de Tempo , Carga Tumoral

RESUMO

INTRODUCTION: Single fraction radiotherapy (SFR) is effective in palliation of symptoms related to advanced cancer. Despite this, several studies have shown that the trend towards multiple fraction treatment (MFR) is largely maintained. Even in patients with limited life expectancy, SFR is significantly underutilized in current practice. CASES DESCRIPTION: Four patients diagnosed with advanced cancer who developed soft tissue lesions were treated with SFR due to frailty and/or a poor performance status. CONCLUSION: Despite the effectiveness of SFR is well-established in BM, its use in symptoms caused by soft tissue lesions have been underreported. SFR could be a good option for providing palliation in some patients, particularly in those who are frail or have a poor performance status.