PO-0905 Validation of a 4D Monte Carlo optimization and planning feature for CyberKnife lung treatment

Trivellato, S.; Rondi, E.; Vigorito, S.; Miglietta, E.; Castellini, Fabio; Piperno, Gaia; Ferrari, Alessio; Jereczek‐Fossa, Barbara Alicja; Cattani, Federica

doi:10.1016/s0167-8140(19)31325-8

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“…Nowadays the upgrade to the Precision® TPS v.1.1.x (Accuray Inc., Sunnyvale, CA) has increased the computational power allowing to run a Monte Carlo calculation in less than 30 minutes. The new Precision® TPS and the Monte Carlo algorithm have been commissioned in our Department at the beginning of 2019 for routine use in the medical practice and in related future research projects [39]. Another criticism of our study is the inclusion of a heterogeneous group of patients.…”

Section: Discussionmentioning

confidence: 99%

Lung optimized treatment with CyberKnife® in inoperable lung cancer patients: feasibility analysis of a mono-institutional 115 patient series

Francia

Marvaso

Piperno

et al. 2020

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CyberKnife® Lung Optimized Treatment (LOT) allows the treatment of lung cancer without invasive fiducial implantation. The aim of this retrospective analysis was to evaluate the feasibility, toxicity and clinical outcome. One hundred fifteen patients (124 lesions) were treated with CyberKnife® using LOT. The median age was 72.6 years (range 31.8-90.3). From 124 treated lesions, 52 were with histopathological confirmation (41 primitive pulmonary cancers, 8 pulmonary metastases) and 72 as untyped tumors. For 5 patients (6 lesions) treatment was an in-field re-irradiation. Concomitant therapy was administered in 7 patients. Zero-View tracking was applied in 69 patients, 1-View in 33 patients, 2-View in 22 patients. The median total dose was 45 Gy (range 18-54), median dose/fraction was 15 Gy (range 4-18) with a median prescription isodose of 80% (range 68-85). The median planning target volume (PTV) was 25 cm 3 (range 3-195). The median followup was 20 months (range 7-47). Thirty-seven patients (32%) were alive with no evidence of disease, 39 patients (34%) were alive with clinically evident disease, and 38 patients (33%) died of the disease. The 1-and 2-year overall survival (OS) rate was 83% and 61%. The median time to progression was 19 months (95% confidence interval: 11-19 months), 1-and 2-year progression-free survival (PFS) rates were 62% and 41%, respectively. Smaller PTV was significantly associated with better OS, PFS and in-field PFS in univariate and multivariate analyses. Acute toxicity was observed in 36 patients (41%). Late toxicity was registered in 25 patients (29%). G3 late toxicity was observed in one patient (1.1%). Our data suggest that fiducial less-stereotactic body radiation therapy (SBRT) is a feasible, well-tolerated and potentially effective treatment with high compliance in the setting of inoperable patients due to concomitant disease or previous treatments.

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Section: Discussionmentioning

confidence: 99%