3674 - Clinical Outcome of Stereotactic Body Radiotherapy In Patients with Early-Stage Lung Cancer with Ground-Glass Components: Multi-Center Experience
Presenter(s)
D. Yang1, F. Zhang2, X. Cai3, J. Yu1, X. Chang1, H. Yu1, R. Yu1, and A. Shi1; 1Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Beijing, China, 2Department of Radiation Oncology, Shanxi Medical University/Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, China, 3Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China, Shanghai, China
Purpose/Objective(s): Stereotactic body radiotherapy (SBRT) has been suggested as an alternative to surgery in inoperable early-stage non-small cell lung cancer(NSCLC)patients. Recent studies have shown that ground-glass opacity (GGO)-dominant lung cancer patients with no systematic mediastinal lymph node dissection had better DFS and less complications. Previous studies have shown that GGO-dominant lesions in SBRT treated early lung cancer patients were associated with better PFS and OS. As a result, SBRT may be a better choice for such patients. However, the relevant studies are limited. Therefore, we performed a retrospective study to investigate the clinical outcome of SBRT in patients with early-stage lung cancer with ground-glass components at multiple centers.
Materials/Methods: We retrospectively analyzed the efficacy of SBRT for early-stage lung cancer with ground-glass nodules (GGN) between December 2013 and August 2025 across multiple medical centers. A total of 134 patients (53 males, 81 females; median age 73.5 years) with 159 nodules (102 with consolidation-to-tumor ratio [CTR] =0.5, 57 with CTR 0.5–<1) were enrolled. All patients had early-stage disease without regional lymph node or distant metastasis. Of these, 109 (81.3%) were medically inoperable and 25 (18.7%) declined surgery; 31 (23.1%) had a history of prior lung cancer resection.Regarding histology, 37 patients (27.6%) were diagnosed with adenocarcinoma, 1 (0.7%) with squamous cell carcinoma, and 3 (2.2%) with non-small cell lung cancer not otherwise specified. A definitive pathological diagnosis was not achieved in 93 patients (69.4%). Overall, 94 patients (70.1%) demonstrated positive uptake on 18F-FDG PET/CT. The remaining patients were diagnosed with malignancy by multidisciplinary team assessment based on tumor enlargement or increased solid component.
Results: The median tumor diameter was 18 mm (range 5–49 mm). All patients underwent SBRT with a median biologically effective dose (BED) of 112.5 Gy (100–144 Gy). With a median follow-up of 56 months (95% CI 10.3–98.8 months), no local recurrence or regional lymph node metastasis was observed. Distant metastasis occurred in 5 patients. The 5-year overall survival (OS) was 93.9%, and the 5-year cancer-specific survival (CSS) was 98.6%. The 5-year CSS was 100% in the CTR =0.5 group and 96.6% in the CTR 0.5–<1 group, with no significant difference (P=0.076). No treatment-related adverse events of grade =3 were reported.
Conclusion: SBRT achieves excellent local control and survival outcomes with favorable safety in patients with early-stage NSCLC containing GGO components and is likely to be considered as an alternative to surgery. Further prospective investigations and prolonged follow-up are warranted.