Radiothérapie stéréotaxique (RTST) pulmonaire des tumeurs de moins de 3 cm (stade I) et 5 cm (stade II) non opérées : 10 ans d’expérience de l’Institut du Cancer de Montpellier (ICM) |
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| Institution: | 1. Service d’oncologie-radiothérapie, institut du cancer de Montpellier, 208, avenue des Apothicaires, 34090 Montpellier, France;2. Service de statistiques, institut du cancer de Montpellier, 208, avenue des Apothicaires, 34090 Montpellier, France;1. Department of Radiation Therapy, centre François-Baclesse, 14000 Caen, France;2. Laboratoire de physique corpusculaire, IN2P3, EnsiCaen, CNRS UMR 6534, Normandie université, 14000 Caen, France;1. Centre of Diagnostic, Therapeutic and Investigative Sciences (CODTIS). Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Aziz, Kuala Lumpur 50300 Malaysia;2. Functional Image Processing Laboratory, Department of Radiology, Universiti Kebangsaan Malaysia Medical Centre, Cheras, Kuala Lumpur 56000, Malaysia;1. Université de Rennes, CLCC Eugène-Marquis, Inserm, LTSI – UMR 1099, 35000 Rennes, France;2. Département de radiothérapie, centre Eugène-Marquis, 35000 Rennes, France;3. Radiotherapy Department, centre Oscar-Lambret, 59000 Lille, France;4. Université de Lille, CNRS, école centrale de Lille, Cristal UMR 9189, Lille, France;5. Department of Radiation Oncology, centre François-Baclesse, 14000 Caen, France;6. Medical physics department, institut de cancérologie de l’Ouest, IMT Atlantique, Nantes université, CNRS/IN2P3, Subatech, Nantes, France;7. Medical Physics, San Raffaele Scientific Institute, Via Olgettina 690, 20132 Milan, Italy;8. Data Science Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy;9. Service de chirurgie oto-rhinolaryngologique (ORL) et chirurgie cervicofaciale, Hôtel-Dieu, CHU de Nantes, Nantes, France;10. Centre Léon-Bérard, Inserm U1296 “Radiation: Defense/Health/Environment”, 69008 Lyon, France;1. Département de radiothérapie, institut Godinot, 1, rue du Général-Koenig, 51100 Reims, France;2. Département d’information médicale, institut Godinot, 1, rue du Général-Koenig, 51100 Reims, France;3. Unité thyroïde, institut Godinot, 1, rue du Général-Koenig, 51100 Reims, France;4. Service de radiothérapie-curiethérapie, Institut de cancérologie Strasbourg Europe (Icans), 17, rue Albert-Calmette, 67200 Strasbourg, France;1. Laboratoire d’imagerie translationnelle en oncologie (Lito), Institut Curie, université PSL, université Paris Saclay, Inserm, 91898 Orsay, France;2. Département de radiothérapie oncologique, institut Curie, université PSL, Centre de protonthérapie, centre universitaire, 91898 Orsay, France;3. Département d’oncologie médicale, institut Curie, Paris, France;4. Département de radiothérapie oncologique, institut Curie, université PSL, Paris, France |
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| Abstract: | PurposeSearch for predictive factors on survival and local control for less than 3 centimeters (cm) (stage I) and 5 cm (stage II) inoperable lung tumors treated by Stereotactic Body Radiation Therapy (SBRT) in a retrospective monocentric study from Montpellier Cancer Institute (ICM)Patients and methodEvery patients treated at ICM for a stage I or II inoperable lung tumors from 2009 to 2019 were analyzed.ResultsOne hundred and seventy nine lesions were treated in 176 patients, with a major part (82,7%) in operated due to chronic obstructive pulmonary disease. Median overall survival for all patients was 71,7 months with a 35 months follow-up and the 2 years loco-regional free survival was 94,0 months. Better associated outcomes were stage I (median overall survival 71,7 versus 29,0 months P = 0,004 ; HR = 2,37 P = 0,005), BED ≥ 150 Gy (median time-to-progression not reached versus 76,7 months P = 0,025), small size of Planning Target Volume (PTV) (HR = 0,42 P = 0,032 when PTV < 15,6 cc). 7,3% of all patients developed radiation pneumonitis.ConclusionSBRT is associated with an excellent overall survival and a high rate of local control for less than 3 cm (stage I) and 5 cm (stage II) lung tumors but a low rate of toxicities. For these patients with many comorbidities, BED over 150 Gy seems to be associated with a better loco-regional free survival, while cause of death is often other than lung cancer. |
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| Keywords: | Stereotactic Body Radiation SBRT Lung cance Montpellier |
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