TY - JOUR
T1 - Tumor volume-adapted dosing in stereotactic ablative radiotherapy of lung tumors
AU - Trakul, Nicholas
AU - Chang, Christine N.
AU - Harris, Jeremy
AU - Chapman, Christopher
AU - Rao, Aarti
AU - Shen, John
AU - Quinlan-Davidson, Sean
AU - Filion, Edith J.
AU - Wakelee, Heather A.
AU - Colevas, A. Dimitrios
AU - Whyte, Richard I.
AU - Dieterich, Sonja
AU - Maxim, Peter G.
AU - Hristov, Dimitre
AU - Tran, Phuoc
AU - Le, Quynh Thu
AU - Loo, Billy W.
AU - Diehn, Maximilian
N1 - Funding Information:
Conflict of interest: B.W.L. has received speaking honoraria from Varian and has consulted for Siemens. M.D., P.G.M., and B.W.L. have received research funding from Varian . B.W.L. has received research support from GE and Philips . The authors report no other conflict of interest.
Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2012/9/1
Y1 - 2012/9/1
N2 - Purpose: Current stereotactic ablative radiotherapy (SABR) protocols for lung tumors prescribe a uniform dose regimen irrespective of tumor size. We report the outcomes of a lung tumor volume-adapted SABR dosing strategy. Methods and Materials: We retrospectively reviewed the outcomes in 111 patients with a total of 138 primary or metastatic lung tumors treated by SABR, including local control, regional control, distant metastasis, overall survival, and treatment toxicity. We also performed subset analysis on 83 patients with 97 tumors treated with a volume-adapted dosing strategy in which small tumors (gross tumor volume <12 mL) received single-fraction regimens with biologically effective doses (BED) <100 Gy (total dose, 18-25 Gy) (Group 1), and larger tumors (gross tumor volume ≥12 mL) received multifraction regimens with BED ≥100 Gy (total dose, 50-60 Gy in three to four fractions) (Group 2). Results: The median follow-up time was 13.5 months. Local control for Groups 1 and 2 was 91.4% and 92.5%, respectively (p = 0.24) at 12 months. For primary lung tumors only (excluding metastases), local control was 92.6% and 91.7%, respectively (p = 0.58). Regional control, freedom from distant metastasis, and overall survival did not differ significantly between Groups 1 and 2. Rates of radiation pneumonitis, chest wall toxicity, and esophagitis were low in both groups, but all Grade 3 toxicities developed in Group 2 (p = 0.02). Conclusion: A volume-adapted dosing approach for SABR of lung tumors seems to provide excellent local control for both small- and large-volume tumors and may reduce toxicity.
AB - Purpose: Current stereotactic ablative radiotherapy (SABR) protocols for lung tumors prescribe a uniform dose regimen irrespective of tumor size. We report the outcomes of a lung tumor volume-adapted SABR dosing strategy. Methods and Materials: We retrospectively reviewed the outcomes in 111 patients with a total of 138 primary or metastatic lung tumors treated by SABR, including local control, regional control, distant metastasis, overall survival, and treatment toxicity. We also performed subset analysis on 83 patients with 97 tumors treated with a volume-adapted dosing strategy in which small tumors (gross tumor volume <12 mL) received single-fraction regimens with biologically effective doses (BED) <100 Gy (total dose, 18-25 Gy) (Group 1), and larger tumors (gross tumor volume ≥12 mL) received multifraction regimens with BED ≥100 Gy (total dose, 50-60 Gy in three to four fractions) (Group 2). Results: The median follow-up time was 13.5 months. Local control for Groups 1 and 2 was 91.4% and 92.5%, respectively (p = 0.24) at 12 months. For primary lung tumors only (excluding metastases), local control was 92.6% and 91.7%, respectively (p = 0.58). Regional control, freedom from distant metastasis, and overall survival did not differ significantly between Groups 1 and 2. Rates of radiation pneumonitis, chest wall toxicity, and esophagitis were low in both groups, but all Grade 3 toxicities developed in Group 2 (p = 0.02). Conclusion: A volume-adapted dosing approach for SABR of lung tumors seems to provide excellent local control for both small- and large-volume tumors and may reduce toxicity.
KW - Biologically effective dose
KW - Lung cancer
KW - Metastases
KW - Stereotactic ablative radiotherapy
KW - Stereotactic body radiation therapy
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U2 - 10.1016/j.ijrobp.2011.10.071
DO - 10.1016/j.ijrobp.2011.10.071
M3 - Article
C2 - 22381907
AN - SCOPUS:84865694578
SN - 0360-3016
VL - 84
SP - 231
EP - 237
JO - International Journal of Radiation Oncology Biology Physics
JF - International Journal of Radiation Oncology Biology Physics
IS - 1
ER -