Modeling local control after hypofractionated stereotactic body radiation therapy for stage I non-small cell lung cancer: A report from the Elekta Collaborative Lung Research Group

Nitin Ohri, Maria Werner-Wasik, Inga S. Grills, José Belderbos, Andrew Hope, Di Yan, Larry L. Kestin, Matthias Guckenberger, Jan Jakob Sonke, Jean Pierre Bissonnette, Ying Xiao

Research output: Contribution to journalArticle

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Abstract

Purpose: Hypofractionated stereotactic body radiation therapy (SBRT) has emerged as an effective treatment option for early-stage non-small cell lung cancer (NSCLC). Using data collected by the Elekta Lung Research Group, we generated a tumor control probability (TCP) model that predicts 2-year local control after SBRT as a function of biologically effective dose (BED) and tumor size. Methods and Materials: We formulated our TCP model as follows: TCP = e[BED10 - c * L - TCD50]/k ÷ (1 + e [BED10 - c * L - TCD50]/k), where BED10 is the biologically effective SBRT dose, c is a constant, L is the maximal tumor diameter, and TCD50 and k are parameters that define the shape of the TCP curve. Least-squares optimization with a bootstrap resampling approach was used to identify the values of c, TCD50, and k that provided the best fit with observed actuarial 2-year local control rates. Results: Data from 504 NSCLC tumors treated with a variety of SBRT schedules were available. The mean follow-up time was 18.4 months, and 26 local recurrences were observed. The optimal values for c, TCD50, and k were 10 Gy/cm, 0 Gy, and 31 Gy, respectively. Thus, size-adjusted BED (sBED) may be defined as BED minus 10 times the tumor diameter (in centimeters). Our TCP model indicates that sBED values of 44 Gy, 69 Gy, and 93 Gy provide 80%, 90%, and 95% chances of tumor control at 2 years, respectively. When patients were grouped by sBED, the model accurately characterized the relationship between sBED and actuarial 2-year local control (r=0.847, P=.008). Conclusion: We have developed a TCP model that predicts 2-year local control rate after hypofractionated SBRT for early-stage NSCLC as a function of biologically effective dose and tumor diameter. Further testing of this model with additional datasets is warranted.

Original languageEnglish (US)
JournalInternational Journal of Radiation Oncology Biology Physics
Volume84
Issue number3
DOIs
StatePublished - Nov 1 2012
Externally publishedYes

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Non-Small Cell Lung Carcinoma
lungs
radiation therapy
Radiotherapy
tumors
cancer
Lung
Research
Neoplasms
dosage
schedules
Least-Squares Analysis
Appointments and Schedules
Recurrence
optimization

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation
  • Cancer Research

Cite this

Modeling local control after hypofractionated stereotactic body radiation therapy for stage I non-small cell lung cancer : A report from the Elekta Collaborative Lung Research Group. / Ohri, Nitin; Werner-Wasik, Maria; Grills, Inga S.; Belderbos, José; Hope, Andrew; Yan, Di; Kestin, Larry L.; Guckenberger, Matthias; Sonke, Jan Jakob; Bissonnette, Jean Pierre; Xiao, Ying.

In: International Journal of Radiation Oncology Biology Physics, Vol. 84, No. 3, 01.11.2012.

Research output: Contribution to journalArticle

Ohri, Nitin ; Werner-Wasik, Maria ; Grills, Inga S. ; Belderbos, José ; Hope, Andrew ; Yan, Di ; Kestin, Larry L. ; Guckenberger, Matthias ; Sonke, Jan Jakob ; Bissonnette, Jean Pierre ; Xiao, Ying. / Modeling local control after hypofractionated stereotactic body radiation therapy for stage I non-small cell lung cancer : A report from the Elekta Collaborative Lung Research Group. In: International Journal of Radiation Oncology Biology Physics. 2012 ; Vol. 84, No. 3.
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abstract = "Purpose: Hypofractionated stereotactic body radiation therapy (SBRT) has emerged as an effective treatment option for early-stage non-small cell lung cancer (NSCLC). Using data collected by the Elekta Lung Research Group, we generated a tumor control probability (TCP) model that predicts 2-year local control after SBRT as a function of biologically effective dose (BED) and tumor size. Methods and Materials: We formulated our TCP model as follows: TCP = e[BED10 - c * L - TCD50]/k ÷ (1 + e [BED10 - c * L - TCD50]/k), where BED10 is the biologically effective SBRT dose, c is a constant, L is the maximal tumor diameter, and TCD50 and k are parameters that define the shape of the TCP curve. Least-squares optimization with a bootstrap resampling approach was used to identify the values of c, TCD50, and k that provided the best fit with observed actuarial 2-year local control rates. Results: Data from 504 NSCLC tumors treated with a variety of SBRT schedules were available. The mean follow-up time was 18.4 months, and 26 local recurrences were observed. The optimal values for c, TCD50, and k were 10 Gy/cm, 0 Gy, and 31 Gy, respectively. Thus, size-adjusted BED (sBED) may be defined as BED minus 10 times the tumor diameter (in centimeters). Our TCP model indicates that sBED values of 44 Gy, 69 Gy, and 93 Gy provide 80{\%}, 90{\%}, and 95{\%} chances of tumor control at 2 years, respectively. When patients were grouped by sBED, the model accurately characterized the relationship between sBED and actuarial 2-year local control (r=0.847, P=.008). Conclusion: We have developed a TCP model that predicts 2-year local control rate after hypofractionated SBRT for early-stage NSCLC as a function of biologically effective dose and tumor diameter. Further testing of this model with additional datasets is warranted.",
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AU - Ohri, Nitin

AU - Werner-Wasik, Maria

AU - Grills, Inga S.

AU - Belderbos, José

AU - Hope, Andrew

AU - Yan, Di

AU - Kestin, Larry L.

AU - Guckenberger, Matthias

AU - Sonke, Jan Jakob

AU - Bissonnette, Jean Pierre

AU - Xiao, Ying

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N2 - Purpose: Hypofractionated stereotactic body radiation therapy (SBRT) has emerged as an effective treatment option for early-stage non-small cell lung cancer (NSCLC). Using data collected by the Elekta Lung Research Group, we generated a tumor control probability (TCP) model that predicts 2-year local control after SBRT as a function of biologically effective dose (BED) and tumor size. Methods and Materials: We formulated our TCP model as follows: TCP = e[BED10 - c * L - TCD50]/k ÷ (1 + e [BED10 - c * L - TCD50]/k), where BED10 is the biologically effective SBRT dose, c is a constant, L is the maximal tumor diameter, and TCD50 and k are parameters that define the shape of the TCP curve. Least-squares optimization with a bootstrap resampling approach was used to identify the values of c, TCD50, and k that provided the best fit with observed actuarial 2-year local control rates. Results: Data from 504 NSCLC tumors treated with a variety of SBRT schedules were available. The mean follow-up time was 18.4 months, and 26 local recurrences were observed. The optimal values for c, TCD50, and k were 10 Gy/cm, 0 Gy, and 31 Gy, respectively. Thus, size-adjusted BED (sBED) may be defined as BED minus 10 times the tumor diameter (in centimeters). Our TCP model indicates that sBED values of 44 Gy, 69 Gy, and 93 Gy provide 80%, 90%, and 95% chances of tumor control at 2 years, respectively. When patients were grouped by sBED, the model accurately characterized the relationship between sBED and actuarial 2-year local control (r=0.847, P=.008). Conclusion: We have developed a TCP model that predicts 2-year local control rate after hypofractionated SBRT for early-stage NSCLC as a function of biologically effective dose and tumor diameter. Further testing of this model with additional datasets is warranted.

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