Survey of the Patterns of Using Stereotactic Ablative Radiotherapy for Early-Stage Non-small Cell Lung Cancer in Korea
Cancer Research and Treatment 2017³â 49±Ç 3È£ p.688 ~ p.694
¼Û»óÇõ(Song Sang-Hyuk) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Radiation Oncology
ÀåÁöÇö(Chang Ji-Hyun) - SMG-SNU Boramae Medical Center Department of Radiation Oncology
±èÇÐÀç(Kim Hak-Jae) - Seoul National University Hospital Department of Radiation Oncology
±è¿¬½Ç(Kim Yeon-Sil) - Catholic University College of Medicine Seoul St. Mary¡¯s Hospital Department of Radiation Oncology
±èÁøÈñ(Kim Jin-Hee) - Keimyung University Hospital Department of Radiation Oncology
¾È¿ëÂù(Ahn Yong-Chan) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Radiation Oncology
±èÀ缺(Kim Jae-Sung) - Seoul National University Bundang Hospital Department of Radiation Oncology
¼Û½Ã¿(Song Si-Yeol) - University of Ulsan College of Medicine Asan Medical Center Department of Radiation Oncology
¹®¼ºÈ£(Moon Sung-Ho) - National Cancer Center Proton Therapy Center
Á¶¹®ÁØ(Cho Moon-June) - Chungnam National University Hospital Department of Radiation Oncology
À±¼±¹Î(Youn Seon-Min) - Eulji University Hospital Department of Radiation Oncology
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.
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Non-small cell lung carcinoma, Stereotactic body radiotherapy, Clinical practice pattern, Surveys and questionnaires
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There were wide variations in the technical protocols and fractionation schedules of SABR for early-stage NSCLC among institutions, although SABR is increasingly being used to treat NSCLC in Korea.