Daniel Kim1,2, Mark M Fuster2,3, Sameer K Nath1,4, Anjali Bharne1, William Read1, Lyudmilla Bazhenova1, William Y Song1,4, Arno J Mundt1,4, Ajay P Sandhu1,5. 1. Department of Medicine, Division of Hematology and Oncology. 2. VA San Diego Healthcare System. 3. Department of Medicine, Division of Pulmonary and Critical Care Medicine; University of California San Diego, La Jolla, CA. 4. Center for Advanced Radiotherapy Technologies. 5. Department of Radiation Oncology, Moores UCSD Cancer Center.
Abstract
ACKNOWLEDGEMENT AND FUNDING: This work was made possible by funding from NIH grant T32 RR023254; Salary support for Dr M.M. Fuster was provided by the Department of Veterans Affairs (BLR&D CDTA Career Development Award). KEYWORDS: Pulmonary metastases; oligometastases; stereotactic body radiotherapy (SBRT); frameless SBRT. BACKGROUND: Lung is a common site of extracranial metastases. Frameless Stereotactic Body Radiation Therapy (SBRT) is a promising new therapy for unresectable neoplastic lung lesions used at our institution. METHODS: A retrospective study of 21 patients and 33 lesions treated with SBRT was done. Local control (LC), distant control (DC), progression-free survival (PFS) and overall survival (OS) were analyzed using the Kaplan-Meier method. Potential prognostic factors were analyzed using the log-rank test and Cox regression. Toxicities were also reported. RESULTS: Actuarial local control rates by lesions were 88% (95% confidence interval [CI], 77-99%) and 76% (95% CI, 59-92%) at 12-and 24-months, respectively. Actuarial local control rates by patients was 80% (95% CI, 62-98%) and 71% (95% CI, 43-100%) for 12- and 24-months, respectively. DC rates were 52% (95% CI 31-74%) and 38% (95% CI, 15-61%), at 12- and 24-months respectively. PFS rates were 52% (95% CI 31-74%) and 32% (95% CI 9-55%) at 12- and 24-months, respectively. Overall survival rates were 90% (95% CI 77-100%) and 78% (95% CI 59-97%) at 12- and 24-months, respectively. Single metastasis was associated with better PFS (p=0.023). No toxicities greater than CTCAE grade 3 were observed. CONCLUSIONS: Frameless SBRT achieves acceptable control in pulmonary metastatic lesions with an excellent toxicity profile.
ACKNOWLEDGEMENT AND FUNDING: This work was made possible by funding from NIH grant T32 RR023254; Salary support for Dr M.M. Fuster was provided by the Department of Veterans Affairs (BLR&D CDTA Career Development Award). KEYWORDS: Pulmonary metastases; oligometastases; stereotactic body radiotherapy (SBRT); frameless SBRT. BACKGROUND: Lung is a common site of extracranial metastases. Frameless Stereotactic Body Radiation Therapy (SBRT) is a promising new therapy for unresectable neoplastic lung lesions used at our institution. METHODS: A retrospective study of 21 patients and 33 lesions treated with SBRT was done. Local control (LC), distant control (DC), progression-free survival (PFS) and overall survival (OS) were analyzed using the Kaplan-Meier method. Potential prognostic factors were analyzed using the log-rank test and Cox regression. Toxicities were also reported. RESULTS: Actuarial local control rates by lesions were 88% (95% confidence interval [CI], 77-99%) and 76% (95% CI, 59-92%) at 12-and 24-months, respectively. Actuarial local control rates by patients was 80% (95% CI, 62-98%) and 71% (95% CI, 43-100%) for 12- and 24-months, respectively. DC rates were 52% (95% CI 31-74%) and 38% (95% CI, 15-61%), at 12- and 24-months respectively. PFS rates were 52% (95% CI 31-74%) and 32% (95% CI 9-55%) at 12- and 24-months, respectively. Overall survival rates were 90% (95% CI 77-100%) and 78% (95% CI 59-97%) at 12- and 24-months, respectively. Single metastasis was associated with better PFS (p=0.023). No toxicities greater than CTCAE grade 3 were observed. CONCLUSIONS: Frameless SBRT achieves acceptable control in pulmonary metastatic lesions with an excellent toxicity profile.
Authors: Sameer K Nath; Ajay P Sandhu; Daniel Kim; Anjali Bharne; Polly D Nobiensky; Joshua D Lawson; Mark Fuster; Lyudmila Bazhenova; William Y Song; Arno J Mundt Journal: Radiother Oncol Date: 2011-03-21 Impact factor: 6.280
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