Stereotactic Radiotherapy for Stage I Non-Small Cell Lung Cancer using Real-Time Tumor Tracking

Lung cancer is the most commonly diagnosed cancer world-wide (1.61 million; 12.7% of the total) and also the leading cause of cancer death (1.38 million; 18.2% of the total). In the Netherlands, lung cancer was diagnosed in almost 11,000 patients in 2007 (website Netherlands Cancer Registry; www.ikcnet.nl). The majority of these patients (77%) have non-small cell lung cancer (NSCLC) and of these patients approximately 20% present with a resectable tumor (website Netherlands Cancer Registry; www.ikcnet.nl). Although surgery is the treatment of choice for patients with resectable tumors, many patients are inoperable due to smoking-related comorbidity. These patients were commonly treated with conventional radiotherapy (≥60 Gy in 2 Gy fractions), but the results were disappointing (51% local tumor control rate and a 15% survival rate at 5 years). Stereotactic body radiotherapy (SBRT) is an alternative treatment currently used for inoperable patients with stage I NSCLC. SBRT delivers a high radiation dose to the tumor in a small number of fractions over a short overall treatment time (typically 48-60 Gy in 3-6 fractions). Although the total dose may seem equal to that in conventional radiotherapy, the high dose per fraction of SBRT (20 Gy versus 2 Gy) is biologically more potent. Thus the biological effective dose (BED) is greater in SBRT than in conventional radiotherapy (BED >100 Gy versus 60 Gy).

• View at Worldcat

Free Full Text ( Final Version , 1mb )