Stereotactic body radiation therapy (SBRT) is a treatment option for patients with early-stage non-small cell lung cancer who are medically inoperable or decline surgery. Here we compare the outcome of patients with centrally located lung tumours who underwent either single fraction (SF)- or five-fraction (FF-) SBRT at a single institution over 5 years.

Between January 2009 and October 2014, patients with centrally located lung tumours who underwent SBRT were included in this study. Data were retrospectively collected using an institutional review board-approved database. For analysis, the Kaplan–Meier method and competing risks method were used.

In total, 11 patients received 26–30 Gy in 1 fraction, whereas 31 patients received 50–60 Gy (median 55 Gy) in 5 fractions. After a median follow-up of 12 months for SF-SBRT and 17 months for FF-SBRT groups (p=0·64), 1-year overall survival rates were 82 and 87%, respectively. SF- and FF-SBRT groups showed no significant difference in grade 3+ toxicity (p=0·28). The only grade 4 toxicity (n=1) was reported in the SF-SBRT group. All toxicities occurred >12 months after the SBRT.

SF- and FF-SBRT have comparable overall survival. SF-SBRT may have some utility for patients unable to have multi-fraction SBRT.

We report a unique presentation of a late side effect associated with stereotactic body radiation therapy (SBRT) of the lung.

The case of a 65-year-old male who developed left-sided vocal cord paralysis after two courses of SBRT for squamous cell lung carcinoma is presented. The patient developed this late toxicity 15 months after his second treatment, which was to address a recurrence in the perihilar region of the left upper lobe.