We treated 53
patients, for a total of 70 lesions. Median age at diagnosis was 70 years
(range: 34.9-93.2), the WHO performance status was 1 in 27/53 pts (51%), 2 in
25/53 pts (47%) and in 1/53 pts (2%).
Twenty out of the 70 lesions were primary pulmonary tumors (28.6%), 32/70 were
stage IV oligometastatic tumors and 18 were lesions treated without biopsy
(25.7%).43/53 pts were treated on one lesion, 6/53 on 2 lesions,3/53 on 3 lesions, 1/53 on 6 lesions. The median diameter of the GTV was 13 mm(range: 4-67). We delivered 50-60Gy in 5 fx. in 29/70, 39Gy in 6 fx. in 1/70, 42Gy in 7 fx. in 1/70, 48Gy
in 8fx. in 38/70 and 60Gy in 10 fx. in 1/70.The SBRT was delivered every 2 days and the median BED was 105Gy (range 62.4-132, α/β=10Gy).Median follow-up was 24 months (range: 3.9-84.9).7 pts presented a progression of the irradiated lesion. The 2-year local control (LC) was 98.4% (95%CI: 89.5-98.9). Noteworthy, we did not see any difference in terms of 2-year LC between lesions treated with or without biopsy (97.9% in both the groups, p-value=0.26). 33 pts presented a lung progression.
The pulmonary relapse-free survival rate was 67% (95%CI: 52.9-77.8) in 2 years.The analysis of the 52 biopsied lesions (32 metastases and 20 primary lung cancers) showed an equivalent 2-year LC (100% vs 95%,respectively; p-value=0.18), but the 2-year lung relapse-free survival rate was 66% for pts with primary cancer and 56% for pts treated for lung metastases (p-value=0.08). The 2-year nodal relapse free survival rate was 67.5% (95%CI:71.1-91.4).
In terms of
acute toxicity >2, we recorded 2 cases of G2 dysphagia and 10 of G2 asthenia. In terms of late toxicity >2, we recorded 1 case of cough, 1 case of G2 lung
toxicity and 10 of G2 asthenia. We also recorded 11 cases of late G3-4 dyspnoea, but only in pts with pulmonary disease progression. In the absence of radiological signs of radiation-induced pneumonia in these 11pts, we attributed the dyspnoea to the progression of the disease.