Review Article

Radiofrequency Ablation for Early-Stage Nonsmall Cell Lung Cancer

Table 2

Summary of recent studies reporting outcomes of SBRT for stage I NSCLC.

Author, year, and
type of study
Reference NumberCenterNumber of patients (stage IA/IB)Patient age (y)Tumor size (cm)Follow-up period (mo)ToxicitiesLocal efficacySurvival

Onishi et al., 2004[24]Yamanashi Medical University in Japan35 (15/20)78*33**13*No grade ≥3 toxicitiesProportion of LTP: 6%2-year OS and CSS: 58% and 83%, respectively

Nagata et al., 2005, prospective[25]Kyoto University in Japan45 (32/13)77* for stage IA and
73* for stage IB
<4.030* for stage IA and
22* for stage IB
No grade ≥3 pulmonary toxicitiesProportion of LTP: 2%1-/2-/3-/5-year OS and DFS for stage IA: 93%/90%/83%/83% and 80%/72%/72%, respectively
1-/2-/3-/5-year OS and DFS for stage IB: 82%/72%/72%/72% and 92%/71%/71%/71%, respectively

Zimmermann et al., 2005[26]Technical University in Germany30 (5/25)60–69
( )
70–79
( )
≥80
( )
NA18* for alive patientsNo grade 5 or 4 toxicities and grade 3 pneumonitis: 3%Proportion of LTP: 7% and
2-year LTP: 13%
1-/2-year OS: 80%/75%, respectively

Nyman et al., 2006[27]Sahlgrenska University in Sweden45 (18/27)74*3.5**43*No grade 5 toxicities and no grade ≥2 radiation pneumonitis Proportion of LTP: 20%1-/2-/3-/5-year OS and CSS: 80%/71%/55%/30% and 88%/83%/67%/41%, respectively, and
median OS and CSS: 39 mo and 55 mo, respectively

Timmerman et al., 2006, prospective[28]Indiana University in US70 (35/35)70*NA18*Grade 5 toxicities: 9% (including pneumonia [6%], pericardial effusion [1%], hemoptysis [1%]) and grade 3 or 4 toxicities: 11%Proportion of LTP: 4% and
2-year LTP: 5%
2-year OS: 55% and median OS: 33 mo

Onishi et al., 2007, retrospective[29]Multicenter in Japan257 (164/93)74*2.8*38*No mortality and grade ≥3 pulmonary toxicities: 5%Proportion of LTP: 14%, 3-/5-year OS and CSS: 57%/47% and 77%/73%, respectively

Baumann et al., 2009, prospective[30]Multicenter in Sweden, Norway, and Denmark57 (40/17)75*2.5*35*No grade 5 toxicities and grade 4/3 toxicities: 2%/28%, respectivelyProportion of LTP: 7% and
3-year LTP: 8%
1-/2-/3-year OS and CSS: 85%/65%/60% and 93%/88%/88%, respectively, and median OS: 41 mo

Fakiris et al., 2009, prospective[31]Indiana University in US70 (34/36)NANA50*Grade 5 toxicities: 7% (including pneumonia [4%], hemoptysis [1%], and respiratory failure [1%]) and
grade 4/3 toxicities: 1%/9%, respectively
Proportion of LTP: 6%,
3-year LTP: 12%
3-year OS/CSS: 43%/82%, respectively, median OS: 32 mo, and median OS for stages IA and IB: 39 mo and 25 mo, respectively

Ricardi et al., 2010, prospective[32]University of Torino in Italy62 (43/19)74*2.4*28*No grade 5 toxicities and grade ≥3 radiation pneumonitis: 3%Proportion of LTP: 6%,
3-y LTP: 12%
2-/3-year OS, CSS, and DFS: 69%/57%, 79%/73%, and 63%/55%, respectively

Timmerman et al., 2010, prospective[33]Multicenter in US and Canada55 (44/11)72*≤5.034*No grade 5 toxicities and grade 4/3 toxicities: 4%/13%, respectivelyProportion of LTP: 2%,
3-y LTP: 2%
3-year OS/DFS: 56%/48%, respectively, and median OS and DFS: 48 mo and 34 mo, respectively

Onishi et al., 2011, retrospective[34]Multicenter in Japan87 (64/23)74*2.1* for stage IA and 3.9* for stage IB55*No grade 5 toxicities, grade 3 pulmonary toxicities: 1%, and
overall grade 3 toxicities: 9%
Overall proportion of LTP: 9%, 5-year overall LTP: 13%, and 5-year LTP for stages IA and IB: 8% and 27%, respectively
5-year OS/CSS: 70%/76%, respectively, and
5-year OS for stages IA and IB: 72% and 63%, respectively

Lagerwaard et al., 2012, prospective[35]VU University Medical Center in Netherlands177 (106/71)76*2.6*32*No grade 5 toxicities and grade ≥3 radiation pneumonitis: 2%Proportion of LTP: 5% and
1-/3-year LTP: 2%/7%, respectively
1-/3-/5-year OS: 95%/85%/51%, respectively, and median OS: 62 mo

Shibamoto et al., 2012, prospective[36]Multicenter in Japan180 (128/52)77*2.7*36*No grade 5 toxicities and grade 3 radiation pneumonitis: 1% 3-year LTP: 17%3-/5-year OS: 69%/52%, respectively, and
3-year OS/CSS for stages IA and IB: 78%/88% and 60%/69%, respectively

Crabtree et al., 2014, retrospective[37]Washington University in US151 (110/41)74**2.6**23*NAProportion of LTP: 11%1-/3-/5-year OS and DFS: 82%/47%/25% and 79%/42%/19%, respectively

 *Median values, **mean values, SBRT = stereotactic body radiation therapy, NSCLC = nonsmall cell lung cancer, NA = not available, LTP = local tumor progression, OS = overall survival, CSS = cancer-specific survival, and DFS = disease-free survival.