A randomized Phase III trial of comparing two dose-fractionations stereotactic body radiotherapy (SBRT) for medically inoperable Stage IA non-small cell lung cancer or small lung lesions clinically diagnosed as primary lung cancer: Japan Clinical Oncology Group Study JCOG1408 (J-SBRT trial)

Kimura, Tomoki; Nagata, Yasushi; Eba, Junko; Ozawa, Shogo; Ishikura, Satoshi; Shibata, Taro; Ito, Yoshiaki; Hiraoka, Masahiro; Nishimura, Yasumasa

doi:10.1093/jjco/hyw198

Cited by 38 publications

(36 citation statements)

References 21 publications

(11 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Stereotactic body radiotherapy (SBRT) is an important therapeutic option for patients with medically inoperable early-stage NSCLC or oligometastatic lung tumors (26)(27)(28). Even for patients in which operative treatment would be viable, SBRT has previously achieved results similar to those of surgery (29)(30)(31), and an increasing number of studies have reported the expansion of factors that may indicate the…”

Section: Introductionmentioning

confidence: 99%

Salvage stereotactic body radiotherapy for post‑operative oligo‑recurrence of non‑small cell lung cancer: A single‑institution analysis of 59�patients

et al. 2020

View full text Add to dashboard Cite

A standard treatment for patients with early-stage non-small cell lung cancer (NSCLC) who undergo surgery, and subsequently develop local failure or intrathoracic oligorecurrence, has not yet been established. The present study aimed to assess the feasibility of stereotactic body radiotherapy (SBRT) for this subgroup of patients. Consequently, a retrospective analysis was conducted of patients with NSCLC recurrence who were treated with SBRT, and previously underwent curative surgical resection between October 2011 and October 2016. Post-SBRT survival [overall survival (OS); progression-free survival (PFS); and local control (LC)] and toxicity were analyzed. Prognostic factors for OS were identified using univariate and multivariate analysis. A total of 52 patients and 59 tumors were analyzed. The median follow-up time was 25 months (35 months for surviving patients), and median OS following salvage SBRT was 32 months. The 1-and 3-year OS rates were 84.4 and 67.8%, respectively. 1-and 3-year PFS rates were 80.8 and 58.7%, respectively. Only 4 patients (7.7%) developed local failure. Median LC was 71 months and 1-and 3-year LC rate were 97.9 and 94.9%, respectively. A total of 4 patients experienced grade 3 or higher adverse events (AEs) and two experienced grade 5 AEs (pneumonitis and hemoptysis). Central tumor location and the possibility of re-operation were independent prognostic factors for OS. The present study indicated that post-operative salvage SBRT is a promising therapeutic option for patients with NSCLC with locoregional or intrathoracic oligo-recurrence. We regard toxicity was also acceptable. However, further research is required on the appropriate selection of subjects, and stratification of the analysis by certain risk factors would increase the accuracy of the conclusions.

show abstract

Section: Introductionmentioning

confidence: 99%

Salvage stereotactic body radiotherapy for post‑operative oligo‑recurrence of non‑small cell lung cancer: A single‑institution analysis of 59�patients

et al. 2020

View full text Add to dashboard Cite

show abstract

“…The treatment plan was created according to the Japan Clinical Oncology Group (JCOG) 1408 study . The phantom was scanned by the CT system under the static motion condition.…”

Section: Methodsmentioning

confidence: 99%

“…For the treatment plans prepared in Sections 2.B and 2.C, the DVH indices were compared for all algorithms. For the evaluation of the DVH indices, D 2% , D 98% , and D 50% of the GTV and PTV, in addition, D 95% of the PTV, the maximum dose received by the tissue 2 cm outside the PTV ( D 2 cm ), and the conformity index (CI) were considered. The CI in this study was defined as:

C I = T V / V,

where

italicTV

is the irradiated volume of the prescription dose, and

V

is the fractional volume of the PTV covered by the prescribed dose or more.…”

Section: Methodsmentioning

confidence: 99%

“…1 were irradiated with the MLC-defined field sizes of 30.8 9 30.8 mm 2 and 60.0 9 61.6 mm 2 and 250 MU. The PDDs were measured using the Semiflex 3D ionization chamber type 31021 with a sensitive volume of 0.07 cm 3 (PTW, Freiburg, Germany) at measured depths of 10,15,20,30,40,50,60,80,100,120,140,150,160,180,200, and 220 mm in the center of the slab phantoms. For the OCR evaluations, Types A and C in Fig.…”

Section: A Basic Evaluations In Homogeneous and Inhomogeneous Phanmentioning

confidence: 99%

“…The treatment plan was created according to the Japan Clinical Oncology Group (JCOG) 1408 study. 20 The phantom was scanned by the CT system under the static motion condition. During CT scanning, an Exradin A16 microchamber (Standard Imaging, Madison, Wis, USA) was inserted into the mock tumor in the lung-equivalent rod.…”

Section: B Clinical Evaluations Using the Lung Motion Phantom Undementioning

confidence: 99%

See 2 more Smart Citations

Evaluation of newly implemented dose calculation algorithms for multileaf collimator‐based CyberKnife tumor‐tracking radiotherapy

et al. 2020

View full text Add to dashboard Cite

Purpose In the previous treatment planning system (TPS) for CyberKnife (CK), multileaf collimator (MLC)‐based treatment plans could be created only by using the finite‐size pencil beam (FSPB) algorithm. Recently, a new TPS, including the FSPB with lateral scaling option (FSPB+) and Monte Carlo (MC) algorithms, was developed. In this study, we performed basic and clinical end‐to‐end evaluations for MLC‐based CK tumor‐tracking radiotherapy using the MC, FSPB+, and FSPB. Methods Water‐ and lung‐equivalent slab phantoms were combined to obtain the percentage depth dose (PDD) and off‐center ratio (OCR). The CK M6 system and Precision TPS were employed, and PDDs and OCRs calculated by the MC, FSPB+, and FSPB were compared with the measured doses obtained for 30.8 × 30.8 mm2 and 60.0 × 61.6 mm2 fields. A lung motion phantom was used for clinical evaluation and MLC‐based treatment plans were created using the MC. The doses were subsequently recalculated using the FSPB+ and FSPB, while maintaining the irradiation parameters. The calculated doses were compared with the doses measured using a microchamber (for target doses) or a radiochromic film (for dose profiles). The dose volume histogram (DVH) indices were compared for all plans. Results In homogeneous and inhomogeneous phantom geometries, the PDDs calculated by the MC and FSPB+ agreed with the measurements within ±2.0% for the region between the surface and a depth of 250 mm, whereas the doses calculated by the FSPB in the lung‐equivalent phantom region were noticeably higher than the measurements, and the maximum dose differences were 6.1% and 4.4% for the 30.8 × 30.8 mm2 and 60.0 × 61.6 mm2 fields, respectively. The maximum distance to agreement values of the MC, FSPB+, and FSPB at the penumbra regions of OCRs were 1.0, 0.6, and 1.1 mm, respectively, but the best agreement was obtained between the MC‐calculated curve and measurements at the boundary of the water‐ and lung‐equivalent slabs, compared with those of the FSPB+ and FSPB. For clinical evaluations using the lung motion phantom, under the static motion condition, the dose errors measured by the microchamber were −1.0%, −1.9%, and 8.8% for MC, FSPB+, and FSPB, respectively; their gamma pass rates for the 3%/2 mm criterion comparing to film measurement were 98.4%, 87.6%, and 31.4% respectively. Under respiratory motion conditions, there was no noticeable decline in the gamma pass rates. In the DVH indices, for most of the gross tumor volume and planning target volume, significant differences were observed between the MC and FSPB, and between the FSPB+ and FSPB. Furthermore, significant differences were observed for lung Dmean, V15 Gy, and V20 Gy between the MC, FSPB+, and FSPB. Conclusions The results indicate that the doses calculated using the MC and FSPB+ differed remarkably in inhomogeneous regions, compared with the FSPB. Because the MC was the most consistent with the measurements, it is recommended for final dose calculations in inhomogeneous regions such as the lung. Furthermore, the sufficient accurac...

show abstract

A virtual audit system for intensity‐modulated radiation therapy credentialing in Japan Clinical Oncology Group clinical trials: A pilot study

Nakamura

Zhou

Minemura³

et al. 2023

J Applied Clin Med Phys

Self Cite

View full text Add to dashboard Cite

The Medical Physics Working Group of the Radiation Therapy Study Group at the Japan Clinical Oncology Group is currently developing a virtual audit system for intensity-modulated radiation therapy dosimetry credentialing. The target dosimeters include films and array detectors, such as ArcCHECK (Sun Nuclear Corporation, Melbourne, Florida, USA) and Delta4 (ScandiDos, Uppsala, Sweden). This pilot study investigated the feasibility of our virtual audit system using previously acquired data. Methods: We analyzed 46 films (32 and 14 in the axial and coronal planes, respectively) from 29 institutions. Global gamma analysis between measured and planned dose distributions used the following settings:3%/3 mm criteria (the dose denominator was 2 Gy), 30% threshold dose, no scaling of the datasets, and 90% tolerance level. In addition, 21 datasets from nine institutions were obtained for array evaluation. Five institutions used ArcCHECK, while the others used Delta4. Global gamma analysis was performed with 3%/2 mm criteria (the dose denominator was the maximum calculated dose), 10% threshold dose, and 95% tolerance level. The film calibration and gamma analysis were conducted with in-house software developed using Python (version 3.9.2). Results: The means ± standard deviations of the gamma passing rates were 99.4 ± 1.5% (range, 92.8%-100%) and 99.2 ± 1.0% (range, 97.0%-100%) in the film and array evaluations, respectively. Conclusion: This pilot study demonstrated the feasibility of virtual audits. The proposed virtual audit system will contribute to more efficient,cheaper,and more rapid trial credentialing than on-site and postal audits; however, the limitations should be considered when operating our virtual audit system.

show abstract

A randomized Phase III trial of comparing two dose-fractionations stereotactic body radiotherapy (SBRT) for medically inoperable Stage IA non-small cell lung cancer or small lung lesions clinically diagnosed as primary lung cancer: Japan Clinical Oncology Group Study JCOG1408 (J-SBRT trial)

Cited by 38 publications

References 21 publications

Salvage stereotactic body radiotherapy for post‑operative oligo‑recurrence of non‑small cell lung cancer: A single‑institution analysis of 59�patients

Salvage stereotactic body radiotherapy for post‑operative oligo‑recurrence of non‑small cell lung cancer: A single‑institution analysis of 59�patients

Evaluation of newly implemented dose calculation algorithms for multileaf collimator‐based CyberKnife tumor‐tracking radiotherapy

A virtual audit system for intensity‐modulated radiation therapy credentialing in Japan Clinical Oncology Group clinical trials: A pilot study

Contact Info

Product

Resources

About