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Stereotactic ablative radiotherapy for early stage non-small cell lung cancer: A critical literature review of predictive factors of relapse

Loganadane, G., Martinetti, F., Mercier, O., (...), Le Péchoux, C., Levy, A.

Cancer Treatment Reviews, Volume 50, November 2016, Pages 240–246

Predicting Relapse in Non-small Cell Lung Cancer Treated with Stereotactic Ablative Radiotherapy

Surgery is a treatment of choice for patients with early non-small cell lung cancer (NSCLC) but isnot always feasible because of the presence of cardiovascular and respiratory co-morbidities.Stereotactic Ablative Radiotherapy (SABR) has recently become an attractive option in borderlineoperable NSCLC and various on-going studies are assessing the efficacy of SABR in NSCLC.

Irrespective of surgical or radiation approach, one of the important aspects to consider whentreating NSCLC is the reduction and prediction of relapse. The predictive factors for relapse inoperated patients have been extensively evaluated in previous literature. However, there are notmuch data on the predictive factors for relapse in patients who have undergone SABR. Hence acritical review of the available literature was performed to evaluate the potential factors whichcould predict relapse in NSCLC treated with SABR.

One of the most important observations of the literature review was the lack of standardization interms of defining the local relapse, prescription criteria and dose calculation for SABR and a lackof generalized procedures for diagnosing relapse. Some of the important predictive factorsassociated with occurrence of relapse which were identified by the review are tumour sizeespecially tumour volume, tumour biology and regional versus distant relapse.

The review concluded that SABR has a potential to become the treatment of choice in not onlyearly NSCLC but also in patients eligible for surgery. However standardization of SABR is ofutmost priority to ensure usefulness of SABR in regular clinical practice.

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