Failure mode.

One of the most common patterns of failure after lung SBRT is distant metastasis. In this study, a multi-institutional database of 1280 lung SBRT patients was used to develop a model that predicted the risk of DM after treatment. The overall rate of DM was approximately 13.4% with a median time to DM of 19.5 months. Factors included in the model were tumor size, SUVmax, age, ECOG PS, history of prior lung cancer, and tumor histology. The model identified a subgroup of patients at highest risk of DM when all of the following were present: age <77, ECOG <2, tumor size >2cm, SUVmax >2.5, and non-squamous histology. At 1 year, the risk of DM was 18.3% in this group compared to 5.6%. A link to the nomogram predictive of 1 year DM risk is available here. | Gao, J Thorac Oncol 2023