Cancer Res Treat.  2017 Jul;49(3):688-694. 10.4143/crt.2016.219.

Survey of the Patterns of Using Stereotactic Ablative Radiotherapy for Early-Stage Non-small Cell Lung Cancer in Korea

Affiliations
  • 1Department of Radiation Oncology, Samsung Medical Center, Seoul, Korea.
  • 2Department of Radiation Oncology, SMG-SNU Boramae Medical Center, Seoul, Korea.
  • 3Department of Radiation Oncology, Seoul National University Hospital, Seoul, Korea. khjae@snu.ac.kr
  • 4Department of Radiation Oncology, Seoul St. Mary's Hospital, Seoul, Korea. yeonkim7@catholic.ac.kr
  • 5Department of Radiation Oncology, Keimyung University Hospital, Daegu, Korea.
  • 6Department of Radiation Oncology, Seoul National University Bundang Hospital, Seongnam, Korea.
  • 7Department of Radiation Oncology, Asan Medical Center, Seoul, Korea.
  • 8Proton Therapy Center, National Cancer Center, Goyang, Korea.
  • 9Department of Radiation Oncology, Chungnam National University Hospital, Daejeon, Korea.
  • 10Department of Radiation Oncology, Eulji University Hospital, Daejeon, Korea.

Abstract

PURPOSE
Stereotactic ablative radiotherapy (SABR) is an effective emerging technique for early-stage non-small cell lung cancer (NSCLC). We investigated the current practice of SABR for early-stage NSCLC in Korea.
MATERIALS AND METHODS
We conducted a nationwide survey of SABR for NSCLC by sending e-mails to all board-certified members of the Korean Society for Radiation Oncology. The survey included 23 questions focusing on the technical aspects of SABR and 18 questions seeking the participants' opinions on specific clinical scenarios in the use of SABR for early-stage NSCLC. Overall, 79 radiation oncologists at 61/85 specialist hospitals in Korea (71.8%) responded to the survey.
RESULTS
SABR was used at 33 institutions (54%) to treat NSCLC. Regarding technical aspects, the most common planning methods were the rotational intensity-modulated technique (59%) and the static intensity-modulated technique (49%). Respiratory motion was managed by gating (54%) or abdominal compression (51%), and 86% of the planning scans were obtained using 4-dimensional computed tomography. In the clinical scenarios, the most commonly chosen fractionation schedule for peripherally located T1 NSCLC was 60 Gy in four fractions. For centrally located tumors and T2 NSCLC, the oncologists tended to avoid SABR for radiotherapy, and extended the fractionation schedule.
CONCLUSION
The results of our survey indicated that SABR is increasingly being used to treat NSCLC in Korea. However, there were wide variations in the technical protocols and fractionation schedules of SABR for early-stage NSCLC among institutions. Standardization of SABR is necessary before implementing nationwide, multicenter, randomized studies.

Keyword

Non-small cell lung carcinoma; Stereotactic body radiotherapy; Clinical practice pattern; Surveys and questionnaires

MeSH Terms

Appointments and Schedules
Carcinoma, Non-Small-Cell Lung*
Electronic Mail
Korea*
Practice Patterns, Physicians'
Radiation Oncology
Radiosurgery
Radiotherapy*
Specialization
Surveys and Questionnaires

Figure

  • Fig. 1. Year in which stereotactic ablative radiotherapy was introduced at each institution.

  • Fig. 2. (A) A 75-year-old male with peripherally located stage I, cT1 (1.6 cm), N0 non-small cell lung cancer (NSCLC) (arrow). (B) A 75-year-old male with medically inoperable stage I, cT2 (4.5 cm), N0 NSCLC (arrow).

  • Fig. 3. Treatment options chosen for each case scenario. SABR, stereotactic ablative radiotherapy.


Reference

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