Stereotactic body radiation therapy for centrally located lung lesions

Joyner, Melissa; Salter, Bill J.; Papanikolaou, Niko; Fuß, Martin

doi:10.1080/02841860600915322

Cited by 57 publications

(33 citation statements)

References 18 publications

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“…However, Timmerman et al reported that the risk of severe toxicity associated with SBRT was elevenfold higher in patients with centrally located lung tumors in comparison to that of patients whose tumors were peripheral [26]. After this landmark report cautioned us against using SBRT to tumors within 2 cm from the main bronchus, a few reports have been published recently which are affirmative for SBRT to the pulmonary hilum [1,12,27]. Joyner et al treated nine patients who had centrally located lung tumors by SBRT with a dose of 36 Gy in three or six fractions (BED 10 ; 57.6 Gy or 46.8 Gy).…”

Section: Discussionmentioning

confidence: 95%

Stereotactic Body Radiotherapy for Lung Tumors at the Pulmonary Hilum

et al. 2010

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Section: Discussionmentioning

confidence: 95%

Stereotactic Body Radiotherapy for Lung Tumors at the Pulmonary Hilum

et al. 2010

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“…Dose escalation and hypofractional dose delivery has the potential to increase patients' survival rates [3] and the probability of local tumor control [4,6,8], while increasing median survival time and long-term progression-free survival [7]. The first dose-response in pulmonary SBRT was reported by Wulf et al [5].…”

Section: Introductionmentioning

confidence: 98%

“…Stereotactic body radiation therapy (SBRT) is emerging as an efficient treatment for Stage I/ II medical inoperable and surgically unresectable non-small-cell and metastatic lung cancer [1][2][3][4][5][6][7][8][9][10][11][12]. Dose escalation and hypofractional dose delivery has the potential to increase patients' survival rates [3] and the probability of local tumor control [4,6,8], while increasing median survival time and long-term progression-free survival [7].…”

Section: Introductionmentioning

confidence: 99%

An evaluation of planning techniques for stereotactic body radiation therapy in lung tumors

Shekhar

et al. 2008

Radiotherapy and Oncology

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Purpose-To evaluate four planning techniques for stereotactic body radiation therapy (SBRT) in lung tumors.Methods and Materials-Four SBRT plans were performed for 12 patients with stage I/II nonsmall-cell lung cancer under the following conditions: (1) conventional margins on free-breathing CT (plan 1), (2) generation of an internal target volume (ITV) using 4DCT with beam delivery under free-breathing conditions (plan 2), (3) gating at end-exhale (plan 3), and (4) gating at end-inhale (plan 4). Planning was performed following the RTOG 0236 protocol with a prescription dose of 54Gy (3 fractions). For each plan 4D dose was calculated using deformable image registration.Results-There was no significant difference in tumor dose delivered by the 4 plans. However, compared with plan 1, plans 2-4 reduced total lung BED by 1.9±1.2Gy, 3.1±1.6Gy and 3.5±2.1Gy, reduced mean lung dose by 0.8±0.5Gy, 1.5±0.8Gy, and 1.6±1.0Gy, reduced V20 by 1.5±1.0%, 2.7 ±1.4%, and 2.8±1.8% respectively with p<0.01. Compared with plan 2, plans 3-4 reduced lung BED by 1.2±1.0Gy and 1.6±1.5Gy, reduced mean lung dose by 0.6±0.5Gy and 0.8±0.7Gy, reduced V20 by 1.2±1.1% and 1.3±1.5% respectively with p<0.01. The differences in lung BED, mean dose and V20 of plan 4 compared with plan 3 are insignificant.Conclusions-Tumor dose coverage was statistically insignificant between all plans. However, compared with plan 1, plans 2-4 significantly reduced lung doses. Compared with plan 2, plan 3-4 also reduced lung toxicity. The difference in lung doses between plan 3 and plan 4 was not significant.

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“…Among those complications, radiation pneumonitis has been the most common; other reported causes are esophageal ulcers, lethal hemoptysis, and major airway stenosis 10,[18][19][20] . When performing sbrt for central tumours that are close to the mediastinal organs, it is necessary to pay attention to the relevant dose constraints.…”

Section: Discussionmentioning

confidence: 99%

Clinical Results of Accelerated Hypofractionated Radiotherapy for Central-Type Small Lung Tumours

et al. 2017

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PurposeWe evaluated the efficacy and toxicity of accelerated hypofractionated radiotherapy (ahypof-rt) for central-type small lung tumours. MethodsBetween November 2006 and January 2015, 40 patients with central-type small lung tumours underwent ahypof-rt delivered using 10 MV X-rays and a coplanar 3-field technique. The number of fractions ranged from 24 to 28, with a fraction size of 2.5-3 Gy. A total dose of 69-75 Gy to the isocentre of the planning target volume was administered to each patient. Cumulative survival and local control rates were calculated using the Kaplan-Meier method. ResultsThe 27 men and 13 women enrolled in the study had a median age of 79 years (range: 60−87 years). The tumour stage was T1a in 9 patients, T1b in 17 patients, and T2a in 14 patients, with a median size of 26.5 cm (range: 11-49 cm). The median follow-up period was 23 months. A complete response was achieved in 3 patients (7.5%), and a partial response, in 17 patients (42.5%). The overall 2-year and 3-year local control rates were 87.3% and 81.8% respectively; the 2-year and 3-year overall survival rates were 78.9% and 66.7% respectively. Grade 3 pneumonitis occurred in 3 patients; no other severe adverse events (≥grade 3) were observed in any patient.Conclusions Accelerated hypofractionated radiotherapy using a fraction size of 2.5-3 Gy was highly safe and can be a more effective treatment option than conventional radiotherapy for patients with central-type small lung tumours.

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Stereotactic body radiation therapy for centrally located lung lesions

Cited by 57 publications

References 18 publications

Stereotactic Body Radiotherapy for Lung Tumors at the Pulmonary Hilum

Stereotactic Body Radiotherapy for Lung Tumors at the Pulmonary Hilum

An evaluation of planning techniques for stereotactic body radiation therapy in lung tumors

Clinical Results of Accelerated Hypofractionated Radiotherapy for Central-Type Small Lung Tumours

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