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Japanese Journal of Clinical Oncology Advance Access published online on October 12, 2009
Japanese Journal of Clinical Oncology, doi:10.1093/jjco/hyp129
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© The Author (2009). Published by Oxford University Press. All rights reserved

Local Control of Metastatic Lung Tumors Treated with SBRT of 48 Gy in Four Fractions: In Comparison with Primary Lung Cancer

Yasushi Hamamoto1, Masaaki Kataoka1, Motohiro Yamashita2, Tetsu Shinkai3, Yoshiro Kubo2, Yoshifumi Sugawara1, Takeshi Inoue1, Shinya Sakai1, Shoji Aono1, Tadaaki Takahashi1, Takatoshi Semba1 and Kotaro Uwatsu1

1 Department of Radiology, Shikoku Cancer Center
2 Department of Surgery, Shikoku Cancer Center
3 Department of Internal Medicine, Shikoku Cancer Center, Matsuyama, Ehime, Japan

For reprints and all correspondence: Yasushi Hamamoto, Department of Radiology, Shikoku Cancer Center, Kou-160, Minamiumemoto-Machi, Matsuyama 791-0280, Ehime, Japan. E-mail: yhamamot{at}shikoku-cc.go.jp

Received June 22, 2009; accepted September 1, 2009

Objective: The optimal dose of stereotactic body radiotherapy (SBRT) for metastatic lung tumors has not been clarified. Local control rates of metastatic lung tumors treated with SBRT of 48 Gy in four fractions, which is one of the common dose schedules for Stage I primary lung cancer in Japan, were examined.

Methods: Between 2006 and 2008, 12 metastatic lung tumors (colorectal cancer, 7; others, 5) in 10 patients and 56 lesions of Stage I primary lung cancer (T1, 43; T2, 13) in 52 patients were treated with SBRT of 48 Gy in four fractions at the isocenter.

Results: Two-year overall survival rates were 86% for patients with metastatic lung tumors and 96% for patients with Stage I primary lung cancer (P = 0.4773). One- and 2-year local control rates were 48% and 25% for metastatic lung tumors, and 91% and 88% for Stage I primary lung cancer, respectively (P < 0.0001).

Conclusions: The local control rates after SBRT of 48 Gy in four fractions were significantly worse in metastatic lung tumors compared with Stage I primary lung cancer. In SBRT, metastatic lung tumors should be clearly differentiated from primary lung cancer and should be given higher doses.

Key Words: stereotactic body radiotherapy • neoplasm metastasis • lung carcinoma


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