Stereotactic Body Radiotherapy of Primary and Secondary Lung Tumors Using CyberKnife and Linear Accelerator: Analysis of Clinical Results, Prognostic Factors and Toxicity
Jánváry Zsolt Levente
Pathological and Oncological Divison
Dr. Matolcsy András
SE Szemészeti Klinika Mária utcai tanterme
2026-04-27 10:00:00
Clinical Oncology and Radiation Therapy
Dr. Polgár Csaba
Dr. Polgár Csaba
Dr. Radeczky Péter
Dr. Maráz Anikó
Dr. Müller Veronika
Dr. Papp Gergő
Dr. Bellyei Szabolcs
The gold standard treatment for lymph node negative, early-stage lung cancer is surgical removal. However, a significant proportion of patients presenting this medical condition, are elderly, suffer from severe chronic lung illnesses, or other comorbidities contraindicating operation. Less frequently, some medically operable patients refuse surgery. Solitary, or oligometastases in the lung, originated from various primary tumors are also conditions could be treated with metastasectomy, but in these cases surgery is a part of a more complex oncological strategy. For these abovementioned situations, stereotactic radiotherapy is a precise, successful non-surgical alternative, however individualized treatment strategy is needed, in function of the size and the location of the target lesions.
The purpose of the thesis was investigation of local and overall effectiveness and safety of lung SBRT in large-scale cohorts after application of risk adapted dose regimens, as well as evaluation of potential predictive factors on survival metrics. Further goal was to confirm the legitimacy of SBRT in patients without histological verification.
Study I. focused on the analysis of 130 patients with 160 pulmonary lesions treated with CyberKnife SBRT. In this mixed cohort of primary, recurrent and secondary tumors in the lung, local control rates, early/late toxicities and factors influencing local effectiveness were investigated.
Study 2. concentrated on a more homogenous, and even larger cohort of a total of 401 early-stage lung cancer patients. Beyond the analysis of local control, local progression-free survival, progression free survival and overall survival, the potential predictive factors, and adverse events were investigated.
In summary, high LC, LPFS, PFS and OS rates were observed, consistently to those reported in the literature, as well as low rates of severe toxicities. In multivariate analysis smaller tumor size and better ECOG performance status predicted better OS, and prescribed BED10 doses of ≥132 Gy predicted better LPFS.
In conclusion, positive clinical experiences with the application of risk adapted dose fractionation, especially 3x18 Gy, 5x12 Gy and 8x7.5 Gy regimens confirmed the successful application of this dose-diversification strategy.
