Background: For stereotactic body radiotherapy (SBRT) to central (C) and ultracentral (UC) lung tumors, our provincial practice has been to prioritize organs at risk (OARs) constraints by compromising target volume coverage if needed. The objectives are to report the treatment's efficacy and safety. Methods: We conducted a retrospective analysis of all provincial patients who underwent SBRT at 60Gy in 8 fractions to C and UC lung tumors, from 2013 to 2017. Results: Ninety-eight lesions were treated, 57 (58.2%) C and 41 (41.8%) UC. The median follow-up was 22.9 months (range 2.5-64.8 months). The 1-and 3-year local control (LC) was 97.8 and 84.5% respectively, with no differences between C and UC groups (p = 0.662). Fifty-three (54.1%) cases had optimal dose coverage (V60Gy ITV&PTV > 95%), 29 (29.6%) had compromised PTV coverage (V60Gy ITV > 95%/PTV < 95%), and 16 (16.3%) had both compromised ITV and PTV coverage (V60Gy ITV&PTV < 95%). No significant difference in LC was detected at 2 years between the 3 groups (95.6, 91.8 and 90.9%, p = 0.717). There were 3 episodes of grade 3 toxicity in the C group (2 dyspnea, 1 pneumonitis) and 2 in the UC group (1 dyspnea, 1 hemoptysis). There were no gr4/5 toxicities. On multivariable Cox regression analysis, ITV size was found to be a predictor for LC (p = 0.001). Conclusions: SBRT at 60Gy in 8 fractions achieves high rates of LC with low risks of significant toxicities, even if target volume coverage is reduced to meet OARs constraints.

Purpose: This study aims to validate the geometric and dosimetric performance of our in‐house ABAS tool using manual inter‐observer variation as benchmark data. Materials and methods: An in‐house ABAS constructed, using MIM MaestroTM version 6.5, from 36 previously treated head and neck cases. 15 OARs of eight nasopharynx patients were segmented via three observers from the same institution and using the in‐house ABAS. Percentage of volume differences (ΔV%,), degree of overlap (DICE), distance‐to‐agreement and the standard deviation of absolute dose difference ΔD SD(Gy) among the eight cases [ΔDmax SD(Gy) for serial organs and ΔDmean SD(Gy) for parallel organs] were compared between the manual segmentation and original ABAS contours for each OAR. Results: The geometric results indicated that ABAS ΔV% was within 1SD from the manual segmentation. DICE showed that manual segmentation marginally outperformed ABAS in the delineation of parotid glands, submandibular glands, and laryngopharynx, but ABSA performed as well as the manual segmentation or better for all other structures. The distance‐to‐agreement was <1.5 cm for 87% of ABAS structures. From a dosimetric perspective, only ABAS salivary glands demonstrated higher ΔD SD(Gy) compared to manual segmentation. For all other structures ABAS results were similar or better than the manual segmentation. The average time to segment a complete H&N OAR set was <3minutes versus 30minutes for manual segmentation. Conclusion: ABAS is a practical time‐saving tool. This study indicated up 90% time‐saving of the operator time per case. ABAS geometric and dosimetric results were within ±1SD inter‐observer variation for most of the structures.

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