PURPOSE: To determine prognostic factors for local control of primary or metastatic tumors within the lung or liver treated with stereotactic body radiation therapy (SBRT) within a single institution. METHODS AND MATERIALS: The records of 141 consecutive patients with 246 lesions treated with three-fraction SBRT from Oct 1999 through Aug 2005 were reviewed. Local control was assessed radiographically. Univariate and multivariate analyses were performed to evaluate the influence of the following factors on local control: total dose, expressed as either nominal prescription dose or equivalent uniform dose (EUD); gross tumor volume; primary site; treatment site (lung vs. other); histologic characteristics (adenocarcinoma vs. other); gender; age; and primary vs. metastatic tumor. RESULTS: On univariate analysis, increased dose (either nominal or EUD) and smaller gross tumor volume were significant predictors of higher local control. Lesions treated to a nominal dose of 54 Gy or greater had a 3-year actuarial local control rate of 89.3% compared with 59.0% and 8.1% for those treated to 36-53.9 Gy and less than 36 Gy. On multivariate analysis, only increased nominal dose and EUD retained statistical significance. Treatment was well tolerated; 5.7% of patients experienced Grade 3 or higher toxicity. CONCLUSIONS: This large single-institution series suggests a dose-control relationship within the range of SBRT doses applied. Excellent local control rates are achieved with a nominal dose of 54 Gy or greater, corresponding to an EUD greater than 65.3 Gy. These results support the use of aggressive SBRT regimens when durable tumor control is the primary objective.
PURPOSE: To determine prognostic factors for local control of primary or metastatic tumors within the lung or liver treated with stereotactic body radiation therapy (SBRT) within a single institution. METHODS AND MATERIALS: The records of 141 consecutive patients with 246 lesions treated with three-fraction SBRT from Oct 1999 through Aug 2005 were reviewed. Local control was assessed radiographically. Univariate and multivariate analyses were performed to evaluate the influence of the following factors on local control: total dose, expressed as either nominal prescription dose or equivalent uniform dose (EUD); gross tumor volume; primary site; treatment site (lung vs. other); histologic characteristics (adenocarcinoma vs. other); gender; age; and primary vs. metastatic tumor. RESULTS: On univariate analysis, increased dose (either nominal or EUD) and smaller gross tumor volume were significant predictors of higher local control. Lesions treated to a nominal dose of 54 Gy or greater had a 3-year actuarial local control rate of 89.3% compared with 59.0% and 8.1% for those treated to 36-53.9 Gy and less than 36 Gy. On multivariate analysis, only increased nominal dose and EUD retained statistical significance. Treatment was well tolerated; 5.7% of patients experienced Grade 3 or higher toxicity. CONCLUSIONS: This large single-institution series suggests a dose-control relationship within the range of SBRT doses applied. Excellent local control rates are achieved with a nominal dose of 54 Gy or greater, corresponding to an EUD greater than 65.3 Gy. These results support the use of aggressive SBRT regimens when durable tumor control is the primary objective.
Authors: Deepinder Singh; Yuhchyau Chen; Mary Z Hare; Kenneth Y Usuki; Hong Zhang; Thomas Lundquist; Neil Joyce; Michael C Schell; Michael T Milano Journal: J Thorac Dis Date: 2014-04 Impact factor: 2.895
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Authors: Sahra Bodo; Cécile Campagne; Tin Htwe Thin; Daniel S Higginson; H Alberto Vargas; Guoqiang Hua; John D Fuller; Ellen Ackerstaff; James Russell; Zhigang Zhang; Stefan Klingler; HyungJoon Cho; Matthew G Kaag; Yousef Mazaheri; Andreas Rimner; Katia Manova-Todorova; Boris Epel; Joan Zatcky; Cristian R Cleary; Shyam S Rao; Yoshiya Yamada; Michael J Zelefsky; Howard J Halpern; Jason A Koutcher; Carlos Cordon-Cardo; Carlo Greco; Adriana Haimovitz-Friedman; Evis Sala; Simon N Powell; Richard Kolesnick; Zvi Fuks Journal: J Clin Invest Date: 2019-01-14 Impact factor: 14.808
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