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A retrospective review covers MPLC patients receiving SBRT between June 2011 and March 2020, with imaging and pathology reviewed in a multidisciplinary tumor board. Dose regimens vary, with local control and overall survival assessed per lesion. Results show high lesion control, median survival of 43.5 months, and limited toxicity mostly grade 1-2.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/multiple-primary-lung-cancers-treatment-outcomes-after-stereotactic-body-radiotherapy-sbrt/381413/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/multiple-primary-lung-cancers-treatment-outcomes-after-stereotactic-body-radiotherapy-sbrt/381413.png","ImageObject",300,407,{"name":92,"@type":93},"Jordan Avery","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-24",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",14,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What types of MPLCs are included in the study?","Question",{"text":113,"@type":114},"The study addresses multiple primary lung cancers presenting either synchronously or metachronously, including cases treated as early-stage MPLCs with definitive SBRT.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How were patients treated and evaluated before SBRT?",{"text":118,"@type":114},"Before definitive SBRT, each patient’s imaging and pathology were reviewed in a multidisciplinary thoracic/pulmonary tumor board, and dose and fractionation varied by prescription.",{"name":120,"@type":111,"acceptedAnswer":121},"What were the main outcome and toxicity findings?",{"text":122,"@type":114},"Local control per lesion was very high (98.6% at one year, 93.3% at two years, and 88.2% at three years) with median overall survival of 43.5 months. Most treated lesions (77.5%) had no subsequent acute or late toxicity, and the toxicity that did occur was mainly grade 1 or grade 2.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},381413,1790618228,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":34,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145},1099523882367,"https://ap-avatar.wpscdn.com/davatar_9964176cb1d06d4a9deccf72a44ae3dc","Open Access Original  \nArticle DOI: 10.7759/cureus.41319  \nReview began 06/26/2023  \nReview ended 06/30/2023  \nPublished 07/03/2023  \n© Copyright 2023  \nChoi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited.  \nMultiple Primary Lung Cancers: Treatment Outcomes After Stereotactic Body Radiotherapy (SBRT)  \nGyujae Choi 1, 2 , George Chen 3, 1 , Weiyuan Mai 4, 1 , Albert Chen 3, 1 , Angela Zhu 4, 1  \n1. Radiation Oncology, Baylor College of Medicine, Houston, USA 2. Radiation Oncology, Multicare Health System, Tacoma, USA 3. Radiation Oncology, Michael E. Debakey Veterans Affairs Medical Center, Houston, USA 4. Radiation Oncology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, USA  \nCorresponding author: Gyujae Choi, [jay.choi010@gmail.com](jay.choi010@gmail.com)  \nAbstract  \nPurpose/objectives: Patients with lung cancer sometimes present with multiple primary lung cancers (MPLCs), either simultaneously (synchronous) or after treatment of an initial lesion (metachronous) . Although open surgery remains a treatment mainstay for patients with stage I-II non-small-cell lung cancer (NSCLC), stereotactic body radiation therapy (SBRT) is an acceptable alternative for patients who are medically unfit for or who refuse surgery. In this study, we retrospectively examine the outcome among patients with early-stage MPLCs treated at our institution with SBRT.  \nMaterials/methods: Patients at our institution receiving SBRT for MPLC between June 2011 and March 2020 were reviewed retrospectively. Prior to undergoing definitive SBRT, the imaging, and pathology for every patient were reviewed in a multi-disciplinary thoracic/pulmonary tumor board. Dose and fractionation varied with the most common prescriptions being 50 Gy/5 fractions, 56 Gy/4 fractions, and 55 Gy/5 fractions.  \nResults: A total of 38 patients with a total of 80 MPLCs were treated, among which 68 were T 1 lesions and 12 were T2 lesions. Median follow-up was 25.9 months, with local control (LC) rates calculated per lesion to be 98.6%, 93.3%, and 88 .2% at one, two, and three years. Median overall survival (OS) was 43.5 months; 83.6%, 67.8%, and 52 .3% at one, two, and three years, respectively. Sixty-two of the 80 (77.5%) treated lesions were not associated with any subsequent acute or late toxicity. The 18 (22 .5%) lesions associated with toxicity included nine acute and nine late events. All toxicity was either grade 1 (13 of 18) or grade 2 (five of 18) .  \nConclusions: SBRT for early-stage MPLC achieves high control rates with limited toxicity. MPLC patients deemed unfit for open surgical management should be considered for definitive SBRT.  \nCategories: Radiation Oncology, Oncology, Pulmonology  \nKeywords: metachronous lung tumors, synchronous lung tumors, multiple primary cancer, stereotactic ablative body radiotherapy, non-small cell lung carcinoma (nsclc)  \nIntroduction  \nPatients with lung cancer sometimes present with multiple primary lung cancers (MPLCs), whether diagnosed with two simultaneous primary cancers (synchronous) or developing a second lesion after treatment of their initial disease (metachronous) . The incidence of MPLCs has been reported to range from 3. 7% to 8%, a finding linked to tobacco carcinogens damaging the entire field at risk [1] .  \nProper staging of an MPLC can significantly impact patient treatment options and prognosis [2] . If the two lesions are considered separate disease processes, then the patient has each lesion staged separately according to the Tumor, Node, Metastasis (TNM), eighth edition staging guidelines by the American Joint Committee on Cancer (AJCC) . If a second lesion is considered a satellite nodule of the index lesion, the patient’s disease is then classified as T3 (nodule in same lung lobe), T4 (nodule in s","cbCaigmTtbYw7dHe","https://ap.wps.com/l/cbCaigmTtbYw7dHe","pdf",281087,"English","# Abstract\n## Purpose/objectives\n## Materials/methods\n## Results\n## Conclusions\n# Introduction\n## Definitions and incidence of MPLCs\n## Staging considerations\n## Treatment context and rationale\n# Materials And Methods","[{\"question\":\"What types of MPLCs are included in the study?\",\"answer\":\"The study addresses multiple primary lung cancers presenting either synchronously or metachronously, including cases treated as early-stage MPLCs with definitive SBRT.\"},{\"question\":\"How were patients treated and evaluated before SBRT?\",\"answer\":\"Before definitive SBRT, each patient’s imaging and pathology were reviewed in a multidisciplinary thoracic/pulmonary tumor board, and dose and fractionation varied by prescription.\"},{\"question\":\"What were the main outcome and toxicity findings?\",\"answer\":\"Local control per lesion was very high (98.6% at one year, 93.3% at two years, and 88.2% at three years) with median overall survival of 43.5 months. Most treated lesions (77.5%) had no subsequent acute or late toxicity, and the toxicity that did occur was mainly grade 1 or grade 2.\"}]","Multiple Primary Lung Cancers - Treatment Outcomes After Stereotactic Body Radiotherapy (SBRT) | PDF",1790245180,18]