Tomoki Kimura1, Yasushi Nagata2, Hideyuki Harada3, Shinya Hayashi4, Yukinori Matsuo5, Tsuyoshi Takanaka6, Masaki Kokubo7, Kenji Takayama7, Hiroshi Onishi8, Koichi Hirakawa9, Yoshiyuki Shioyama10, Takeshi Ehara11. 1. Department of Radiation Oncology, Graduate School of Biomedical Sciences, Hiroshima University Hospital, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8551, Japan. tkkimura@hiroshima-u.ac.jp. 2. Department of Radiation Oncology, Graduate School of Biomedical Sciences, Hiroshima University Hospital, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8551, Japan. 3. Division of Radiation Oncology, Shizuoka Cancer Center, Shizuoka, Japan. 4. Department of Radiology, Gifu University, Gifu, Japan. 5. Department of Radiation Oncology and Image-applied Therapy, Kyoto University Graduate School of Medicine, Kyoto, Japan. 6. Department of Radiation Oncology, Kanazawa University, Kanazawa, Japan. 7. Division of Radiation Oncology, Institute of Biomedical Research and Innovation Hospital, Kobe, Japan. 8. Department of Radiology, University of Yamanashi, Yamanashi, Japan. 9. Department of Radiology, Saga University, Saga, Japan. 10. Department of Clinical Radiology, Kyushu University, Fukuoka, Japan. 11. Department of Radiation Oncology, Saitama Medical University International Medical Center, Saitama, Japan.
Abstract
BACKGROUND: To investigate the maximum tolerated dose (MTD) and recommended dose (RD) of stereotactic body radiation therapy (SBRT) for centrally located stage IA non-small cell lung cancer (NSCLC). METHODS: Five dose levels, ranging from of 52 to 68 Gy in eight fractions, were determined; the treatment protocol began at 60 Gy (level 3). Each dose level included 10 patients. Levels 1-2 were indicated if more than four patients exhibited dose-limiting toxicity (DLT), which was defined as an occurrence of a grade 3 (or worse) adverse effect within 12 months after SBRT initiation. MTD was defined as the lowest dose level at which more than four patients exhibited DLT. RESULTS: Ten patients were enrolled in the level 3 study. One patient was considered unsuitable because of severe emphysema. Therefore, nine patients were evaluated and no patient exhibited DLT. The level 3 results indicated that we should proceed to level 4 (64 Gy). However, due to the difficulty involved in meeting the dose constraints, further dose escalation was not feasible and the MTD was found to be 60 Gy. CONCLUSIONS: The RD of SBRT for centrally located stage IA NSCLC was 60 Gy in eight fractions.
BACKGROUND: To investigate the maximum tolerated dose (MTD) and recommended dose (RD) of stereotactic body radiation therapy (SBRT) for centrally located stage IA non-small cell lung cancer (NSCLC). METHODS: Five dose levels, ranging from of 52 to 68 Gy in eight fractions, were determined; the treatment protocol began at 60 Gy (level 3). Each dose level included 10 patients. Levels 1-2 were indicated if more than four patients exhibited dose-limiting toxicity (DLT), which was defined as an occurrence of a grade 3 (or worse) adverse effect within 12 months after SBRT initiation. MTD was defined as the lowest dose level at which more than four patients exhibited DLT. RESULTS: Ten patients were enrolled in the level 3 study. One patient was considered unsuitable because of severe emphysema. Therefore, nine patients were evaluated and no patient exhibited DLT. The level 3 results indicated that we should proceed to level 4 (64 Gy). However, due to the difficulty involved in meeting the dose constraints, further dose escalation was not feasible and the MTD was found to be 60 Gy. CONCLUSIONS: The RD of SBRT for centrally located stage IA NSCLC was 60 Gy in eight fractions.
Entities:
Keywords:
Centrally located stage IA; Non-small cell lung cancer (NSCLC); Phase I; SBRT
Authors: Robert Timmerman; Rebecca Paulus; James Galvin; Jeffrey Michalski; William Straube; Jeffrey Bradley; Achilles Fakiris; Andrea Bezjak; Gregory Videtic; David Johnstone; Jack Fowler; Elizabeth Gore; Hak Choy Journal: JAMA Date: 2010-03-17 Impact factor: 56.272
Authors: S Adebahr; S Collette; E Shash; M Lambrecht; C Le Pechoux; C Faivre-Finn; D De Ruysscher; H Peulen; J Belderbos; R Dziadziuszko; C Fink; M Guckenberger; C Hurkmans; U Nestle Journal: Br J Radiol Date: 2015-04-15 Impact factor: 3.039
Authors: Victor S Mangona; Andrew M Aneese; Ovidiu Marina; Richard V Hymas; Dan Ionascu; John M Robertson; Lori J Gallardo; Inga Siiner Grills Journal: Int J Radiat Oncol Biol Phys Date: 2014-10-18 Impact factor: 7.038
Authors: Joe Y Chang; Suresh Senan; Marinus A Paul; Reza J Mehran; Alexander V Louie; Peter Balter; Harry J M Groen; Stephen E McRae; Joachim Widder; Lei Feng; Ben E E M van den Borne; Mark F Munsell; Coen Hurkmans; Donald A Berry; Erik van Werkhoven; John J Kresl; Anne-Marie Dingemans; Omar Dawood; Cornelis J A Haasbeek; Larry S Carpenter; Katrien De Jaeger; Ritsuko Komaki; Ben J Slotman; Egbert F Smit; Jack A Roth Journal: Lancet Oncol Date: 2015-05-13 Impact factor: 41.316
Authors: Shervin M Shirvani; Jing Jiang; Joe Y Chang; James Welsh; Anna Likhacheva; Thomas A Buchholz; Stephen G Swisher; Benjamin D Smith Journal: JAMA Surg Date: 2014-12 Impact factor: 14.766
Authors: Bryan P Rowe; Daniel J Boffa; Lynn D Wilson; Anthony W Kim; Frank C Detterbeck; Roy H Decker Journal: J Thorac Oncol Date: 2012-09 Impact factor: 15.609