PURPOSE: We examined the rate of acute skin toxicity within a prospectively managed database of patients treated for early-stage non-small-cell lung cancer (NSCLC) and investigated factors that might predict skin toxicity. METHODS: From May 2006 through January 2008, 50 patients with Stage I NSCLC were treated at Memorial Sloan-Kettering Cancer Center with 60 Gy in three fractions or 44-48 Gy in four fractions. Patients were treated with multiple coplanar beams (3-7, median 4) with a 6 MV linac using intensity-modulated radiotherapy (IMRT) and dynamic multileaf collimation. Toxicity grading was performed and based on the National Cancer Institute Common Terminology Criteria for Adverse Effects. Factors associated with Grade 2 or higher acute skin reactions were calculated by Fisher's exact test. RESULTS: After a minimum 3 months of follow-up, 19 patients (38%) developed Grade 1, 4 patients (8%) Grade 2, 2 patients (4%) Grade 3, and 1 patient Grade 4 acute skin toxicity. Factors associated with Grade 2 or higher acute skin toxicity included using only 3 beams (p = 0.0007), distance from the tumor to the posterior chest wall skin of less than 5 cm (p = 0.006), and a maximum skin dose of 50% or higher of the prescribed dose (p = 0.02). CONCLUSIONS: SBRT can be associated with significant skin toxicity. One must consider the skin dose when evaluating the treatment plan and consider the bolus effect of immobilization devices.
PURPOSE: We examined the rate of acute skin toxicity within a prospectively managed database of patients treated for early-stage non-small-cell lung cancer (NSCLC) and investigated factors that might predict skin toxicity. METHODS: From May 2006 through January 2008, 50 patients with Stage I NSCLC were treated at Memorial Sloan-Kettering Cancer Center with 60 Gy in three fractions or 44-48 Gy in four fractions. Patients were treated with multiple coplanar beams (3-7, median 4) with a 6 MV linac using intensity-modulated radiotherapy (IMRT) and dynamic multileaf collimation. Toxicity grading was performed and based on the National Cancer Institute Common Terminology Criteria for Adverse Effects. Factors associated with Grade 2 or higher acute skin reactions were calculated by Fisher's exact test. RESULTS: After a minimum 3 months of follow-up, 19 patients (38%) developed Grade 1, 4 patients (8%) Grade 2, 2 patients (4%) Grade 3, and 1 patient Grade 4 acute skin toxicity. Factors associated with Grade 2 or higher acute skin toxicity included using only 3 beams (p = 0.0007), distance from the tumor to the posterior chest wall skin of less than 5 cm (p = 0.006), and a maximum skin dose of 50% or higher of the prescribed dose (p = 0.02). CONCLUSIONS: SBRT can be associated with significant skin toxicity. One must consider the skin dose when evaluating the treatment plan and consider the bolus effect of immobilization devices.
Authors: K Guidolin; B Yaremko; K Lynn; S Gaede; A Kornecki; G Muscedere; I BenNachum; O Shmuilovich; M Mouawad; E Yu; T Sexton; N Gelman; V Moiseenko; M Brackstone; M Lock Journal: Curr Oncol Date: 2019-06-01 Impact factor: 3.677
Authors: Simon S Lo; Achilles J Fakiris; Eric L Chang; Nina A Mayr; Jian Z Wang; Lech Papiez; Bin S Teh; Ronald C McGarry; Higinia R Cardenes; Robert D Timmerman Journal: Nat Rev Clin Oncol Date: 2009-12-08 Impact factor: 66.675
Authors: James Welsh; Jimmy Thomas; Deep Shah; Pamela K Allen; Xiong Wei; Kevin Mitchell; Song Gao; Peter Balter; Ritsuko Komaki; Joe Y Chang Journal: Int J Radiat Oncol Biol Phys Date: 2010-06-11 Impact factor: 7.038
Authors: Hyejoo Kang; Ellen D Yorke; Jie Yang; Chen-Shou Chui; Kenneth E Rosenzweig; Howard I Amols Journal: J Appl Clin Med Phys Date: 2010-06-08 Impact factor: 2.102