{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T13:45:16Z","timestamp":1790257516140,"version":"4.1.0"},"reference-count":29,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2016,10,14]],"date-time":"2016-10-14T00:00:00Z","timestamp":1476403200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2017,2,15]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Stereotactic body radiotherapy (SBRT) is the standard of care for patients with nonoperative, early\u2010stage non\u2013small cell lung cancer (NSCLC) measuring\u2009&lt;\u20095\u2009cm, but its use among patients with tumors measuring \u22655\u2009cm is considerably less defined, with the existing literature limited to small, single\u2010institution reports. The current multi\u2010institutional study reported outcomes evaluating the largest such population reported to date.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Clinical\/treatment characteristics, outcomes, toxicities, and patterns of failure were assessed in patients with primary NSCLC measuring \u22655\u2009cm without evidence of distant\/lymph node metastasis who underwent SBRT using \u22645 fractions. Statistics included Kaplan\u2010Meier survival analyses and univariate\/multivariate Cox proportional hazards models.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>A total of 92 patients treated from 2004 through 2016 were analyzed from 12 institutions. The median follow\u2010up was 12 months (15 months in survivors). The median age and tumor size among the patients were 73 years (range, 50\u201095 years) and 5.4\u2009cm (range, 5.0\u20107.5\u2009cm), respectively. The median dose\/fractionation was 50 Gray\/5 fractions. The actuarial local control rates at 1 year and 2 years were 95.7% and 73.2%, respectively. The disease\u2010free survival rate was 72.1% and 53.5%, respectively, at 1 year and 2 years. The 1\u2010year and 2\u2010year disease\u2010specific survival rates were 95.5% and 78.6%, respectively. The median, 1\u2010year, and 2\u2010year overall survival rates were 21.4 months, 76.2%, and 46.4%, respectively. On multivariate analysis, lung cancer history and pre\u2010SBRT positron emission tomography maximum standardized uptake value were found to be associated with overall survival. Posttreatment failures were most commonly distant (33% of all disease recurrences), followed by local (26%) and those occurring elsewhere in the lung (23%). Three patients had isolated local failures. Grade 3 to 4 toxicities included 1 case (1%) and 4 cases (4%) of grade 3 dermatitis and radiation pneumonitis, respectively (toxicities were graded according to the Common Terminology Criteria for Adverse Events [version 4.0]). Grades 2 to 5 radiation pneumonitis occurred in 11% of patients. One patient with a tumor measuring 7.5\u2009cm and a smoking history of 150 pack\u2010years died of radiation pneumonitis.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>The results of the current study, which is the largest study of patients with NSCLC measuring \u22655\u2009cm reported to date, indicate that SBRT is a safe and efficacious option. <jats:bold><jats:italic>Cancer<\/jats:italic> 2017;123:688\u2013696.<\/jats:bold> \u00a9 <jats:italic>2016 American Cancer Society<\/jats:italic>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.30375","type":"journal-article","created":{"date-parts":[[2016,10,14]],"date-time":"2016-10-14T15:42:46Z","timestamp":1476459766000},"page":"688-696","source":"Crossref","is-referenced-by-count":79,"title":["Multi\u2010institutional experience of stereotactic body radiotherapy for large (\u22655 centimeters) non\u2013small cell lung tumors"],"prefix":"10.1002","volume":"123","author":[{"given":"Vivek","family":"Verma","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology University of Nebraska Medical Center Omaha Nebraska"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerie K.","family":"Shostrom","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, College of Public Health University of Nebraska Medical Center Omaha Nebraska"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sameera S.","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of Kentucky Lexington Kentucky"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weining","family":"Zhen","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of Nebraska Medical Center Omaha Nebraska"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher L.","family":"Hallemeier","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Mayo Clinic Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve E.","family":"Braunstein","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of California at San Francisco San Francisco California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Holland","sequence":"additional","affiliation":[{"name":"Department of Radiation Medicine Oregon Health and Science University Portland Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew M.","family":"Harkenrider","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Loyola University Stritch School of Medicine Maywood Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"S. 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