Repeated Stereotactic Body Radiotherapy for Lung Malignancies: Toxicity Can Be Reduced by Sparing Lung Irradiation

Watanabe, S; Yamazaki, Hideya; Kimoto, Takyua; Suzuki, Gen; Yamada, Kazutaka

doi:10.21873/anticanres.15748

Cited by 2 publications

(2 citation statements)

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“…In addition, SBRT is indicated as an alternative to surgery in patients whose lung function is already impaired with heterogeneous lung function distribution and greater sensitivity to even minimal loss of lung capacity [ 2 ]. Finally, the development of cancer treatments (targeted therapies, immunotherapy) [ 3 ] has led to an improvement in patient survival but also to an increase in the number of recurrences and indications for re-irradiation, particularly with a highly conformal technique such as SBRT [ 22 ]. Thus, a better sparing of the pulmonary functional areas with each course of SBRT could lead to higher possibilities of re-irradiation or to limit the risks of toxicities of these re-irradiations [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

A Feasibility Study of Functional Lung Volume Preservation during Stereotactic Body Radiotherapy Guided by Gallium-68 Perfusion PET/CT

Lucia

Hamya

Pinot

et al. 2023

Cancers

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The aim of this study was to assess the feasibility of sparing functional lung areas by integration of pulmonary functional mapping guided by 68Ga-perfusion PET/CT imaging in lung SBRT planification. Sixty patients that planned to receive SBRT for primary or secondary lung tumors were prospectively enrolled. Lung functional volumes were defined as the minimal volume containing 50% (FV50%), 70% (FV70%) and 90% (FV90%) of the total activity within the anatomical volume. All patients had a treatment planning carried out in 2 stages: an anatomical planning blinded to the PET results and then a functional planning respecting the standard constraints but also incorporating “lung functional volume” constraints. The mean lung dose (MLD) in functional volumes and the percentage of lung volumes receiving xGy (VxGy) within the lung functional volumes using both plans were calculated and compared. SBRT planning optimized to spare lung functional regions led to a significant reduction (p < 0.0001) of the MLD and V5 to V20 Gy in all functional volumes. Median relative difference of the MLD in the FV50%, FV70% and FV90% was −8.0% (−43.0 to 1.2%), −7.1% (−34.3 to 1.2%) and −5.7% (−22.3 to 4.4%), respectively. Median relative differences for VxGy ranged from −12.5% to −9.2% in the FV50%, −11.3% to −7.2% in the FV70% and −8.0% to −5.3% in the FV90%. This study shows the feasibility of significantly decreasing the doses delivered to the lung functional volumes using 68Ga-perfusion PET/CT while still respecting target volume coverage and doses to other organs at risk.

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Section: Discussionmentioning

confidence: 99%

A Feasibility Study of Functional Lung Volume Preservation during Stereotactic Body Radiotherapy Guided by Gallium-68 Perfusion PET/CT

Lucia

Hamya

Pinot

et al. 2023

Cancers

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“…Radiation pneumonitis is frequently observed after repeat SBRT. Watanabe et al previously showed that a mean lung dose and lung volume spared from low-dose irradiation may be useful in predicting radiation pneumonitis after repeat SBRT (12). Therefore, we plan to introduce deformable image registration and perform cumulative dose summation to evaluate the safety of the reirradiation.…”

Section: Kaplan-meier Plot For the Local Control (Lc) (A) Cause-speci...mentioning

confidence: 99%

Clinical Outcomes of Stereotactic Body Radiation Therapy for Early-stage Non-small Cell Lung Cancer

Tasaki

Ashizawa

Nakamura

et al. 2023

CDP

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Background/Aim: To investigate the clinical outcomes of stereotactic body radiotherapy (SBRT) in patients with early-stage non-small cell lung cancer (NSCLC). Patients and Methods: Among consecutive patients with early-stage NSCLC who received SBRT between November 2009 and September 2019, those with cT1-2N0M0 staged by the UICC TNM classification and staging system for lung cancer were retrospectively analyzed. Results: Fifty-three patients with early-stage NSCLC received SBRT. The median follow-up period was 29 months (range=2-105 months). Twenty-one lung tumors were clinically diagnosed as early-stage primary lung cancers without histological confirmation. Histological examinations revealed adenocarcinoma in 24 patients and squamous cell carcinoma in 8. Two- and 5-year local control, cancer-specific survival, progression-free survival (PFS), and overall survival (OS) rates were 94.4 and 94.4%; 94.6 and 90.8%; 69.0 and 43.3%; and 80.0 and 59.3%, respectively. In a univariate analysis, the T stage, histology, and type of pulmonary nodule correlated with PFS and OS. Conclusion: Good clinical outcomes were achieved by patients with early-stage NSCLC who received SBRT.

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Repeated Stereotactic Body Radiotherapy for Lung Malignancies: Toxicity Can Be Reduced by Sparing Lung Irradiation

Cited by 2 publications

References 0 publications

A Feasibility Study of Functional Lung Volume Preservation during Stereotactic Body Radiotherapy Guided by Gallium-68 Perfusion PET/CT

A Feasibility Study of Functional Lung Volume Preservation during Stereotactic Body Radiotherapy Guided by Gallium-68 Perfusion PET/CT

Clinical Outcomes of Stereotactic Body Radiation Therapy for Early-stage Non-small Cell Lung Cancer

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