INTRODUCTION:Radiotherapy is widely used in the treatment of early-stage laryngeal cancer (stage I and II). We analyzed the efficacy of conventional and accelerated fractionated radiotherapy (52.5 Gy in 16 fractions) for early-stage laryngeal cancer retrospectively. MATERIALS AND METHODS:We compared the outcomes of 25 patients treated with conventional fractionation (CF group: 66-70 Gy in 33-35 fractions) and 20 patients treated with accelerated fractionation (AF group: 52.5 Gy in 16 fractions) radiotherapy from 2011 to 2024 at our institution. RESULTS:Local control rate was 87.8% at five years in the CF group and 95% at five years in the AF group. Acute adverse events were significantly higher in the CF group, with 72% Grade 2 or higher dermatitis compared to 20% in the AF group (p < 0.01). No serious late adverse events of Grade 2 or higher were observed in either group. The COVID-19 pandemic increased the use of AF from 34.3% before COVID-19 to 66.7% afterwards, suggesting that AF is a reasonable option as a curative strategy; AF has a shorter overall treatment time (median 22 days), better local control rates, and fewer adverse events. CONCLUSION:Accelerated fractionated radiotherapy of 52.5 Gy in 16 fractions for early-stage laryngeal cancer is a safe and effective option for patients with poor performance status, older age, severe comorbidities, or difficulty with long-term hospital stays, offering a shorter overall treatment time without affecting the cure rate.

Objective:This study aimed to examine the reliability and validity of the Japanese version of the MD Anderson Symptom Inventory Head and Neck Tumor module (MDASI-HN), a patient-reported outcome measure for head and neck cancer. Methods:The MDASI-HN was translated into Japanese, and cognitive debriefing was conducted. A cross-sectional study was administered to patients with head and neck cancer who were recruited within 5 years of receiving surgery, chemotherapy, or radiotherapy at three cancer treatment centers. The reliability and validity of the Japanese version were confirmed through structural equation modeling, internal consistency, test-retest reliability, convergent validity, known-groups validity. Results:The Japanese translation of the MDASI-HN was revised with developer feedback. Cognitive debriefing with five patients provided positive feedback regarding the ease of completion and understanding. A cross-sectional sample of 147 patients completed the questionnaire. Structural equation modeling showed a Confirmatory Fit Index of 0.975 and Root Mean Square Error of Approximation of 0.059. The Cronbach's alpha coefficient was 0.88 for head and neck cancer-specific items and 0.96 for all symptom items. The Intraclass Correlation Coefficients (2,1) were 0.72 for HNC-specific items and 0.74 for all items. The convergent validity with the EORTC QLQ-H&N module was r ​= ​0.79. The known-groups validity showed small to moderate effect sizes for all subitems, based on the comparison of mean ECOG Performance Status Scale scores between the two groups. Conclusions:The results showed that the translated MSASI-HN was reliable, valid, and feasible for use in Japanese-speaking patients with head and neck cancer.

Surgery is the standard treatment for stage I non-small cell lung cancer (NSCLC); however, no clear randomized trial demonstrates its superiority to stereotactic body radiotherapy (SBRT) regarding survival. We aimed to retrospectively evaluate the treatment outcomes of SBRT in operable patients with stage I NSCLC using a large Japanese multi-institutional database to show real-world outcome. Exactly 399 patients (median age 75 years; 262 males and 137 females) with stage I (IA 292, IB 107) histologically proven NSCLC (adenocarcinoma 267, squamous cell carcinoma 96, others 36) treated at 20 institutions were reviewed. SBRT was prescribed at a total dose of 48–70 Gy in 4–10 fractions. The median follow-up period was 38 months. Local progression-free survival rates were 84.2% in all patients and 86.1% in the T1, 78.6% in T2, 89.2% in adenocarcinoma, and 70.5% in squamous cell subgroups. Overall 3-year survival rates were 77.0% in all patients: 90.7% in females, 69.6% in males, and 41.2% in patients with pulmonary interstitial changes. Fatal radiation pneumonitis was observed in two patients, all of whom had pulmonary interstitial changes. This real-world evidence will be useful in shared decision-making for optimal treatment, including SBRT for operable stage I NSCLC, particularly in older patients.

at least 5 years beyond radiotherapy.The median age was 56 years old, 89% of the enrolled patients had stage III-IVA NPC by AJCC/UICC 8 th Edition, and 87% of patients received chemotherapy.The mean MoCA score was 23.6, 25.8% of patients were considered cognitively impaired.NPC survivors demonstrated significant cognitive impairment in verbal memory (p<0.001),processing speed (p<0.001),executive function (p<0.001),motor dexterity (p<0.001) and language ability (p=0.001).Most significant impairment was observed in executive function, mean z-scores of which were -1.76 to -1.38 below normative data.Post-IMRT interval, disease stage and chemotherapy usage showed no significant association with the degree of neurocognitive impairment.Conclusion: Post-IMRT neurocognitive impairment was prevalent in NPC survivors.Neurocognitive function was not impaired globally but occurred predominantly in selected domains, particularly executive function.Cognitive assessment and training should be considered a part of survivorship care for NPC patients.Future research on the correlation between neurocognitive function and radiation dosimetry of various brain subsites would be informative.

Abstract Background JCOG1015A1 is an ancillary research study to determine the organ-specific dose constraints in head and neck carcinoma treated with intensity-modulated radiation therapy (IMRT) using data from JCOG1015. Methods Individual patient data and dose-volume histograms of organs at risk (OAR) were collected from 74 patients with nasopharyngeal carcinoma treated with IMRT who enrolled in JCOG1015. The incidence of late toxicities was evaluated using the cumulative incidence method or prevalence proportion. ROC analysis was used to estimate the optimal DVH cut-off value that predicted toxicities. Results The 5-year cumulative incidences of Grade (G) 1 myelitis, ≥ G1 central nervous system (CNS) necrosis, G2 optic nerve disorder, ≥ G2 dysphagia, ≥ G2 laryngeal edema, ≥ G2 hearing impaired, ≥ G2 middle ear inflammation, and ≥ G1 hypothyroidism were 10%, 5%, 2%, 11%, 5%, 26%, 34%, and 34%, respectively. Significant associations between DVH parameters and incidences of toxicities were observed in the brainstem for myelitis (D1cc ≥ 55.8 Gy), in the brain for CNS necrosis (D1cc ≥ 72.1 Gy), in the eyeball for optic nerve disorder (Dmax ≥ 36.6 Gy), and in the ipsilateral inner ear for hearing impaired (Dmean ≥ 44 Gy). The optic nerve, pharyngeal constrictor muscle (PCM), and thyroid showed tendencies between DVH parameters and toxicity incidence. The prevalence proportion of G2 xerostomia at 2 years was 17 versus 6% (contralateral parotid gland Dmean ≥ 25.8 Gy vs less). Conclusions The dose constraint criteria were appropriate for most OAR in this study, although more strict dose constraints might be necessary for the inner ear, PCM, and brainstem.

A phase II study of adaptive two-step intensity-modulated radiotherapy (IMRT) with chemotherapy for nasopharyngeal cancer (NPC) (JCOG1015) was conducted to evaluate the efficacy and safety. Patients aged 20–75 years with stages II–IVB NPC were enrolled. As adaptive two-step IMRT, computed tomography planning was performed twice before IMRT for the initial plan of 46 Gy/23 fractions and during treatment for the boost plan of 24 Gy/12 fractions with a total dose of 70 Gy. Chemotherapy (cisplatin 80 mg/m2/3-weeks × 3 courses) was administered concurrently with IMRT, followed by adjuvant chemotherapy (cisplatin at 70 mg/m2 with 5-FU 700 at mg/m2 for 5 days/4 weeks × 3 courses). Between 2011 and 2014, 75 patients were enrolled from 12 institutions. The 3-year overall survival (OS) for the 75 patients was 88%, and the upper and lower limits of the 95% CI of 78%–94% were higher than the expected 3-year OS of 75% for the target population adjusted by the actual proportion of stage II:III:IV = 21%:44%:35%. The 3-year progression-free survival (PFS) and loco-regional PFS were 71% [59–80%] and 77% [66–85%], respectively. Although no grade 4–5 late toxicities were observed, 15 patients (20%) developed grade 3 late toxicities. Grade 2 xerostomia was noted in 26%, 12%, and 9% at 1, 2, and 3 years after starting IMRT, respectively. Adaptive two-step IMRT for NPC demonstrated an excellent 3-year OS with acceptable toxicities. This method may be one treatment option for locally advanced NPC.

ABSTRACT Combining external beam radiotherapy (EBRT) with intracavitary brachytherapy (ICBT) is important for definitive treatment of cervical cancer. In cervical cancer patients receiving radiotherapy, we evaluated treatment outcomes in relation to dose–volume histogram parameters, including the computed tomography (CT)-based high-risk clinical target volume (HR-CTV) for ICBT. Between 2010 and 2015, 89 consecutive cervical cancer patients were mostly treated with 40 Gy of EBRT in 20 fractions and 18 Gy of ICBT prescribed to point A in 3 fractions. CT scans were obtained during ICBT. The HR-CTV D90 was calculated and the total doses of ICBT and EBRT were converted to the equivalent dose in 2 Gy fractions (EQD2). When the patients were divided into four groups according to EQD2 of the HR-CTV D90, the 3-year local recurrence-free survival rates were 95.2, 78.4, 52.7 and 42.9% for patients receiving >80 , 70–80 , 60–70 and <60 Gy, respectively. There was a significant negative correlation between EQD2 of the HR-CTV D90 and the HR-CTV volume at first ICBT (r = −0.713). Local recurrence was more frequent when the HR-CTV volume was ≥22 cc and EQD2 of the HR-CTV D90 was <70 Gy. Multivariate analysis showed that EQD2 of the HR-CTV D90 and concurrent chemotherapy (≥4 cycles) were significant determinants of overall survival. HR-CTV D90 was an important prognostic indicator for local recurrence. HR-CTV D90 >70 Gy is required for the better local control, especially in patients with a larger HR-CTV (≥22 cc at initial ICBT).

To evaluate radiotherapy-induced changes in the expression of programmed death ligand 1 (PD-L1), programmed death 1 (PD-1), and human leukocyte antigen class I (HLA-1) in patients with uterine cervical cancer, as well as infiltration of CD8+ and Forkhead box P3+ (FoxP3+) T lymphocytes into tumor tissue and the prognostic value of these parameters. We performed immunohistochemical analysis of pre-radiotherapy biopsies and corresponding post-radiotherapy resected tissues in 104 uterine cervical cancer patients undergoing preoperative chemoradiotherapy or radiotherapy alone. We scored the expression of various proteins to distinguish positive from negative samples. PD-L1-expressing tumor cells (PD-L1 TC) increased significantly after chemoradiotherapy (p = 0.043). CD8+ T cell infiltration (p = 0.002) and FoxP3+ T cell infiltration (p = 0.003) decreased significantly after chemoradiotherapy. Expression of PD‑1, PD-L1-expressing immune cells (PD-L1 IC), and HLA‑1 did not change after chemoradiotherapy. In biopsy specimens obtained before chemoradiotherapy or radiotherapy, greater infiltration of CD8+ T cells (p = 0.001) and FoxP3+ T cells (p = 0.003) were significant predictors of better overall survival (OS). In surgical specimens obtained after chemoradiotherapy or radiotherapy, greater infiltration of PD-L1 TC was the only significant predictor of better OS (p < 0.001) and was related to a significantly lower probability of out-of-field recurrence (p = 0.005). Chemoradiotherapy induced an immunologic shift that increased PD-L1 TC. Chemoradiotherapy has immunological effects that can influence the results of treatment for uterine cervical cancer.

Purpose We previously reported early efficacy results from a phase I/II study of definitive chemoradiotherapy using docetaxel, nedaplatin and 5-fluorouracil (DNF-R), and confirmed strong antitumor activity with an acceptable early toxicity profile for patients with esophageal cancer. Here, we present the long-term results of the study including late toxicity and survival. Methods Thirty-one patients were enrolled. Patients received 5-fluorouracil (400 mg/m2 civ, d1-5 and d8-12), nedaplatin (50 mg/m2 on d1 and 8), and docetaxel (20-30 mg/m2 on d1 and 8), repeated twice every 5 weeks with concurrent radiotherapy (59.4Gy/33fr). Study objectives in the phase II part included the CR rate, progression-free survival (PFS), overall survival (OS), and safety. Results Between December 2008 and February 2014, a total of 28 patients were registered. Grade 3/4 acute toxicities included neutropenia (43%), febrile neutropenia (7%), thrombocytopenia (18%), and esophagitis (21%). Grade 3/4 late toxicity included esophagostenosis (11%) and pleural effusion (7%), though these resolved with dilation and thoracic drainage, respectively. All patients achieved a response, with 23 (82.1%) CR cases (stege II/III 89%, T4/M1LYM 67%). With a median follow-up time of 69.8 months, the 3-/5-year PFS and OS were 68.4/68.4% and 71.5/66.8%, respectively. 5-year OS for stage II/III (nonT4) and T4/M1LYM were 68.4% and 28.6%, respectively. Conclusions The long-term results show that efficacy was maintained with high rate of PFS and OS compared with those of historical control, with durable responses and acceptable safety profile. DNF-R might be a promising regimen for definitive CRT for esophageal cancer.

【目的】皮膚癌に対して短期間での根治治療を目的として行った4分割放射線治療について報告する。

To evaluate the relationship between the distance from the superior irradiation field border to the aortic bifurcation and non-regional lymph node recurrence (NRLR) in uterine cervical cancer patients treated with definitive radiotherapy. We retrospectively investigated patients with uterine cervical cancer who had received definitive radiotherapy between January 2000 and December 2013 at our hospital. Ninety-four patients were included in this study. According to the International Federation of Obstetrics and Gynecology staging system (FIGO 2008), 14 patients were in stage I, 37 patients were in stage II, 33 patients were in stage III, and 10 patients were in stage IV. Thirty-two patients (34 %) had pelvic lymph node metastasis (N1) at the time of diagnosis. Fifty-three patients (56.4 %) were treated with concurrent chemoradiotherapy. Each external beam radiotherapy field was reviewed and the distance from the superior border of the irradiation field to the aortic bifurcation was measured. The non-regional lymph node recurrence-free survival rate (NRFS) was calculated by the Kaplan-Meier method, and differences in NRFS were evaluated by the log-rank test. All tests were two-sided, and a p value < 0.05 was considered statistically significant. The median follow-up time was 64 months (range 2 – 188 months). There were 35 patients (37.2 %) whose bifurcations were above L4 - L5 interspace. The irradiation field superior border was L4 – L5 interspace in 81 patients (86.2 %). When comparing the superior border to the level of the aortic bifurcation, the border was 1 cm or more caudal in direction to the bifurcation in 28 patients (lower group) (29.8 %) and 1cm or more cranial in direction in 20 patients (21.3 %). NRLR occurred in 19 patients. Of these, 9 patients were initially pelvic node negative (N0), and the rest of the 10 patients were N1. The 5-year NRFS was 83.2 % for the N0 and 64.7 % for the N1, respectively (p = 0.04). With regard to the superior border of the irradiated field to the level of the aortic bifurcation, the 5-year NRFS was 68.5 % in the lower group and 80.9 % in the other group (non-lower group) (p = 0.21). When limited to the N0 group, the 5-year NRFS was significantly worse in the lower group than in the non-lower group (67.5 % versus 91.3 %, p = 0.02). The N1 group had higher NRLR compared to the N0 group. In the N0 group, it could prove prudent to keep a sufficient superior margin of the irradiation field to the aortic bifurcation.

The purpose of this study was to clarify the prognosis after recurrence or metastases on local tumor, regional lymph node, or distant organ in medically operable stage I non-small cell lung cancer NSCLC patients treated by stereotactic body radiotherapy (SBRT). We organized a multi-institutional SBRT study group of 20 institutions in Japanese Radiological Society (JRS-SBRTSG) and conducted a retrospective analysis to review 156 medically operable patients (median age, 75 years; male 119, female 37; adenocarcinoma 83, squamous cell carcinoma 37, others 36) who were treated with SBRT for stage I (IA 100, IB 56) NSCLC, and had local recurrence or metastases on somewhere of regional lymph node or distant organ. A total dose of 36 -70 Gy mainly at the isocenter was prescribed in 4-15fractions. The median calculated biological effective dose (BED) was 108 Gy (range, 64-150 Gy) based on alpha/beta = 10Gy). Local recurrence and metastases were judged according to continuously increasing in size or 18F-FDG PET-positive finding. The survival curves of local tumor, regional lymph node, and distant organ were calculated using Kaplan-Meir method. The median follow-up period was 36 months. At the last observation period, the cases of local tumor recurrence, regional lymph node metastases, and distant organ metastases were 60 cases, 67 cases, and 107 cases respectively. Combined other sites recurrence or metastases was found in 61.7%, 70.1%, and 51.4% of the recurrence local recurrence, regional lymph node metastases, and distant organ metastases, respectively. The mean times to the local recurrence, regional lymph node metastases, and distant organ metastases from the start of SBRT were 23 months, 17 months, and 22 months, respectively. The mean survival times after the local recurrence, regional lymph node metastases, and distant organ metastases were 21 months, 13 months, and 12 months, respectively. The mean survival times after isolated local recurrence, regional lymph node metastases, and distant organ metastases were 22 months, 17 months, and 13 months, respectively. The overall survival rate was statistically better in female group than male group after the lymph node or distant organ metastases, but not different after the local recurrence. The survival rate was not different after any recurrence or metastases between stage IA versus IB nor adenocarcinoma versus squamous cell carcinoma. The survival time after the recurrence or metastases in medically operable stage I NSCLC treated by SBRT was short in order of distant organ metastases, regional lymph node metastases, and local recurrence. This result provided a useful information for prediction of the prognosis after the recurrence or metastases.

Some studies showed that clinical response to immune check point inhibitors is lower in acral and mucosal melanoma than in cutaneous melanoma. Although the synergistic effect of radiotherapy (RT) and ipilimumab has been reported in patients with brain metastasis, the efficacy of combined RT and anti-programmed death 1 (PD-1) therapy for acral and mucosal melanoma is unclear. The present study aimed to evaluate the efficacy of combined RT and anti-PD-1 therapy for acral and mucosal melanoma. We retrospectively analyzed patients with acral or mucosal melanoma who were treated with anti-PD-1 and RT at Sapporo Medical University Hospital. In 10 patients (acral, 3; mucosal, 7), the response rate (RR) and the disease control rate (DCR) were 40% and 60%, respectively. As regards mucosal melanoma, four of the seven patients had achieved complete response + partial response, and three had progressive disease (RR = 57.1%). Meanwhile, two of the three patients with acral melanoma had stable disease and one had progressive disease (RR and DCR were 0% and 66.6%, respectively). Except for the patients treated with palliative RT for bone metastasis in the present study, the RR was 50% (4/8 patients), and the DCR was 75% (6/8 patients). Vitiligo developed after RT in five (50%) patients at a median duration of 2 months after RT. The clinical response and the high occurrence of vitiligo suggest that the combination of RT and anti-PD-1 therapy could be effective in some patients with mucosal melanoma.

Pretreatment pulmonary interstitial change (PIC) has been indicated as a risk factor of severe radiation pneumonitis (RP) following stereotactic body radiation therapy (SBRT) for early-stage lung cancer, but details of its true effect remain unclear. This study aims to evaluate treatment outcomes of SBRT for stage I non-small cell lung cancer in patients with PIC. A total of 242 patients are included in this study (88% male). The median age is 77 years (range, 55–92 years). A total dose of 40–70 Gy is administered in 4 to 10 fractions during a 4-to-25 day period. One, two, and three-year overall survival (OS) rates are 82.1%, 57.1%, and 42.6%, respectively. Fatal RP is identified in 6.9% of all patients. The percent vital capacity <70%, mean percentage normal lung volume receiving more than 20 Gy (>10%), performance status of 2–4, presence of squamous cell carcinoma, clinical T2 stage, regular use of steroid before SBRT, and percentage predicting forced expiratory volume in one second (<70%) are associated with worse prognoses for OS. Our results indicate that fatal RP frequently occurs after SBRT for stage I lung cancer in patients with PIC.

BackgroundWe assessed the non-inferiority of accelerated fractionation (AF) (2.4 Gy/fraction) compared with standard fractionation (SF) (2 Gy/fraction) regarding progression-free survival (PFS) in patients with T1-2N0M0 glottic cancer (GC).Patients and methodsIn this multi-institutional, randomized, phase III trial, patients were enrolled from 32 Japanese institutions. Key inclusion criteria were GC T1-2N0M0, age 20-80, Eastern Cooperative Oncology Group performance status of 0-1, and adequate organ function. Patients were randomly assigned to receive either SF of 66-70 Gy (33-35 fractions), or AF of 60-64.8 Gy (25-27 fractions). The primary end point was the proportion of 3-year PFS. The planned sample size was 360 with a non-inferiority margin of 5%.ResultsBetween 2007 and 2013, 370 patients were randomized (184/186 to SF/AF). Three-year PFS was 79.9% (95% confidence interval [CI] 73.4-85.4) for SF and 81.7% (95% CI 75.4-87.0) for AF (difference 1.8%, 91% CI-5.1% to 8.8%; one-sided P = 0.047 > 0.045). The cumulative incidences of local failure at 3 years for SF/AF were 15.9%/10.3%. No significant difference was observed in 3-year overall survival (OS) between SF and AF. Grade 3 or 4 acute and late toxicities developed in 22 (12.4%)/21 (11.5%) and 2 (1.1%)/1 (0.5%) in the SF/AF arms.ConclusionAlthough the non-inferiority of AF was not confirmed statistically, the similar efficacy and toxicity of AF compared with SF, as well as the practical convenience of its fewer treatment sessions, suggest the potential of AF as a treatment option for early GC.Clinical trials registrationUMIN Clinical Trial Registry, number UMIN000000819.

Background and purpose: To investigate influences of proteins involved with tumor immunity on outcomes of radiotherapy for oropharyngeal squamous cell carcinoma (OPSCC). Material and methods: We performed immunohistochemical staining to examine expressions of p16 and proteins involved with tumor immunity in 92 OPSCC patients treated with radiotherapy. Results: Patients with abundant infiltrating CD8-positive cells had the significantly better overall survival (OS) rate than patients with fewer CD8-positive cells (p = 0.026). Patients with higher PD-L1 expression in tumor cells (TC 1-3) had a better outcome than those with low PD-L1 expression in tumor cells (TC 0) for both OS (p = 0.019) and progression-free survival (PFS) rate (p = 0.032). Patients with high PD-L1 expression in infiltrating immune cells (IC 3) showed significantly better OS (p = 0.009) and PFS (p = 0.011) than those with low PD-L1 expression (IC 0-2). Patients with p16-negative and IC 3 showed similar OS to patients with p16-positive and IC 0-2. P16-positive tumors had a significantly higher CD8-positive cell infiltration and PD-L1 expression in tumor cells than p16-negative tumors. Conclusions: In addition to tumor p16 expression, PD-L1 expression in TC and IC can be useful for predicting the response of OPSCC to radiotherapy. (C) 2018 Published by Elsevier B.V.

BACKGROUND:To search for novel biomarkers that can predict acute radiation toxicity, we conducted microRNA expression analysis of peripheral blood lymphocytes (PBLs).METHODS:The discovery cohort was 69 patients with localized adenocarcinoma of the prostate who received intensity-modulated radiation therapy between October 2007 and October 2010. The validation cohort was 72 patients treated with low-dose-rate brachytherapy between May 2008 and March 2014. After13 microRNAs were selected by TaqMan® Array analysis in a preliminary experiment, expression of these microRNAs in all samples was analyzed by RT-PCR.RESULTS:In the discovery cohort, the average prostate volume, the rectal volume receiving 70 Gy, and expression of miR-410 and miR-221 were significant risk factors for Grade 1-2 gastrointestinal toxicity. Receiver operating characteristic analysis showed that the area under the curve (AUC) was 0.807. The maximum dose to the urinary bladder, prostate volume, pretreatment urinary function score, and miR-99a and miR-221 expression were risk factors for Grade 2 genitourinary toxicity. The corresponding AUC was 0.796. In the validation cohort, reproducibility of these markers was confirmed for gastrointestinal toxicity, but not for genitourinary toxicity.CONCLUSION:Combining radiation dose parameters with microRNA expression in PBLs may be useful for predicting acute gastrointestinal toxicity of radiation therapy, thus contributing to personalized treatment of prostate cancer.

The popularization of computed tomography (CT) in clinical practice have increased a frequency of discovering ground-glass opacity (GGO)-containing tumor in lung. Surgery has been regarded as the general treatment including a purpose of histological examination for such tumors and its prognosis is better than that of solid-type tumors. Stereotactic body radiation therapy (SBRT) is a rapidly prevailing treatment modality in the radical treatment of mainly inoperable or high risk operable cases with stage I non-small cell lung cancer (NSCLC), but the most tumors treated with SBRT were solid type because SBRT has been performed principally for the pathology-proven tumors and it is generally difficult to acquire histological specimen in the tumors composed of GGO. Therefore a prognosis of the stage I NSCLC cases treated with SBRT when their tumors contained GGO has not been clear. The purpose of this presentation is to review the treatment outcomes for SBRT for the patients with GGO-containing tumor in our multi-institutional SBRT study group of Japanese Radiological Society (JRS-SBRTSG), and to discuss how we consider the validity of SBRT for them.