Lung stereotactic body radiation therapy using simultaneous integrated BED-escalation for peripherally located non-small cell lung cancer

Purpose: Report the outcomes of patients with non-small cell lung cancer (NSCLC) and peripheral tumors treated with simultaneous integrated biologically equivalent dose (BED)-escalation (SIBE) lung stereotactic body radiation therapy (SBRT) to achieve dose escalation.

Materials/methods: Patients with NSCLC within 5 mm of the chest wall treated with a SIBE approach were eligible. Patients received 60 Gy in 5 fractions, with dose decreased to 50 Gy based on proximity to the chest wall. Dosimetry, oncologic outcomes, and toxicity were evaluated.

Results: Twenty-four patients met inclusion criteria. Median BED to the PTV was 135.4 Gy. Median chest wall V30 was 18.7 cc. The 3-year LC, OS, and PFS of the non-metastatic cohort was 93%, 35%, and 39%, respectively. The crude rate of chest wall toxicity was 12.5%, with no rib fractures.

Conclusions: SIBE lung SBRT appears to be well tolerated and achieves favorable local control rates and survival.