Stereotactic Body Radiotherapy for Central and Ultracentral Lung Tumors: A Multicenter Real-world Outcomes Analysis.
Abstract
Aims
The aim of the study is to evaluate real-world clinical outcomes of stereotactic body radiotherapy (SBRT) for central (C) and ultracentral (UC) lung tumors, with a focus on toxicity, tumor control, and overall survival (OS).
Materials And Methods
This multicenter retrospective analysis included 133 patients with C or UC lung tumors treated with SBRT across multiple participating centers. Patient characteristics, treatment parameters, toxicity outcomes, tumor control, and OS were analyzed retrospectively.
Results
Grade 2 toxicity occurred in 30.1% (n = 31/103) of patients with C tumors and 26.7% (n = 8/30) with UC tumors, while grade 3 toxicity was observed in 8.7% and 16.7% of patients, respectively. Median OS was 24 months. Favorable outcomes were observed in patients with epidermal growth factor receptor (EGFR)-mutant disease and smaller planning target volumes (PTVs). Delivery of SBRT in conjunction with systemic therapies was feasible and associated with manageable toxicity profiles.
Conclusion
In this multicenter real-world cohort, SBRT for C and UC lung tumors was associated with acceptable toxicity and clinically meaningful outcomes when delivered using contemporary techniques and cautious fractionation. Observations in selected subgroups, including patients with EGFR-mutant disease and smaller PTVs, should be interpreted as hypothesis-generating and support individualized clinical decision-making in anatomically high-risk settings.