Stereotactic body radiotherapy for chronic obstructive pulmonary disease patients undergoing or eligible for long-term domiciliary oxygen therapy

A major cause of death in patients undergoing long-term domiciliary oxygen therapy (ltot) is lung cancer progression. in our institution,we actively perform stereotactic body radiotherapy (sbrt) on patients with early-stage non-small-cell lung cancer undergoing ltot. in this study,we retrospectively analyzed the treatment efficacy and safety of sbrt for patients with t1-3n0m0 non-small-cell lung cancer who had been prescribed ltot for treatment of chronic obstructive pulmonary disease (copd). a total of 24 patients were studied. their median age was 74 years (range,63-87 years). the median duration from the start of ltot to sbrt was 23 months (range,0-85 months). four of the 24 patients underwent lobectomy due to lung cancer. the median follow-up duration was 29 months (range,5-79 months). one patient had a local recurrence. the median survival time was 30 months. the 3-year overall survival was 49%. in 6 of the 24 patients (25%),copd presented with interstitial pneumonia. the 3-year overall survival for patients with copd without interstitial pneumonia was significantly better than that for patients with both copd and interstitial pneumonia (67% and 0%,respectively; p < 0.0001). grade 5 radiation pneumonitis occurred in one patient (4%) with copd with interstitial pneumonia. sbrt was tolerated by patients with early-stage non-small-cell lung cancer undergoing ltot. sbrt should be considered for patients undergoing ltot. however,clinicians should consider the risk of severe radiation pneumonitis in patients with interstitial pneumonia. © 2015 the author 2015.