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Jeffrey Bradley, MD  Journal of Thoracic Oncology 

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1 Radiographic Response and Clinical Toxicity Following SBRT for Stage I Lung Cancer 
Jeffrey Bradley, MD  Journal of Thoracic Oncology  Volume 2, Issue 7, Pages S118-S124 (July 2007) DOI: /JTO.0b013e318074e50c Copyright © 2007 International Association for the Study of Lung Cancer Terms and Conditions

2 FIGURE 1 Diffuse consolidation after stereotactic body radiation therapy. This patient received 54 Gy in three fractions to a left upper lobe cancer prescribed to the 85% isodose line. Her follow-up computed tomography (CT) scan obtained 6 weeks following SBRT showed a radiographic response. However, her chest CT at 6 months was concerning for local recurrence. A flurodeoxyglucose positron emission tomography (PET) was obtained to help differentiate between recurrence and fibrosis. The PET reading suggested an inflammatory response but could not rule out recurrence. This patient has been followed for 18 months and is without recurrence. Journal of Thoracic Oncology 2007 2, S118-S124DOI: ( /JTO.0b013e318074e50c) Copyright © 2007 International Association for the Study of Lung Cancer Terms and Conditions

3 FIGURE 2 Patchy consolidation and ground-glass opacity (GGO) after stereotactic body radiation therapy. This patient received 60 Gy in three fractions to a right upper lobe cancer prescribed to the 80% isodose line. His follow-up computed tomography (CT) scan at 6 weeks showed stable disease. CT at 6 months demonstrated an improved response with residual patchy consolidation and GGO. Positron emission tomography (PET) showed no evidence of residual cancer. This patient has been followed for 20 months and is without recurrence. Journal of Thoracic Oncology 2007 2, S118-S124DOI: ( /JTO.0b013e318074e50c) Copyright © 2007 International Association for the Study of Lung Cancer Terms and Conditions

4 FIGURE 3 No evidence of increasing density. This patient received 54 Gy in three fractions to this right lower lobe cancer prescribed to the 85% isodose line. His follow-up computed tomography scan demonstrated tumor regression followed by a complete radiographic response. This patient remains without evidence of recurrence 36 months following stereotactic body radiation therapy. Journal of Thoracic Oncology 2007 2, S118-S124DOI: ( /JTO.0b013e318074e50c) Copyright © 2007 International Association for the Study of Lung Cancer Terms and Conditions

5 FIGURE 4 Scarlike pattern of radiation fibrosis. This patient received 54 Gy in three fractions to his right lung cancer. Computed tomography (CT) obtained 6 weeks after therapy demonstrated a radiographic response. The CT and positron emission tomography/CT scans obtained 12 months after therapy showed no evidence of recurrent cancer. A scarlike band is seen posterior to the original tumor location with associated volume loss. Journal of Thoracic Oncology 2007 2, S118-S124DOI: ( /JTO.0b013e318074e50c) Copyright © 2007 International Association for the Study of Lung Cancer Terms and Conditions

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