Lorenzo Falcinelli1, Monia Mendichi2, Sara Chierchini3, Maria Valentina Tenti2, Rita Bellavita1, Simonetta Saldi1, Gianluca Ingrosso4, Valentina Reggioli5, Vittorio Bini6, Cynthia Aristei4. 1. Radiation Oncology Section, Perugia General Hospital, Perugia, Italia. 2. Radiation Oncology Unit, University of Perugia, Perugia, Italia. 3. Radiation Oncology Unit, University of Perugia, Perugia, Italia. sarachierchini@gmail.com. 4. Radiation Oncology Unit, University of Perugia and Perugia General Hospital, Perugia, Italia. 5. Medical Physics Section, Perugia General Hospital, Perugia, Italia. 6. Endocrine and Metabolic Science Unit, University of Perugia, Perugia, Italia.
Abstract
AIMS: This retrospective study reports outcomes after stereotactic body radiation therapy (SBRT) as delivered by helical tomotherapy (HT) for lung lesions. It promotes a dose escalation program. METHODS: Histological and/or radiological findings and/or case histories identified 41 primary and 15 metastatic lesions. Thirty patients received 40 Gy in 5 fractions (BED 72 Gy10Gy) and 26 50 Gy in 5 fractions (BED 100Gy10Gy). Primary end point was lung toxicity. Secondary end points were respiratory function, local control and local progression-free survival. RESULTS: Acute toxicity developed in 18/56 patients and late toxicity in 8/54. Median FEV-1 variations versus baseline were - 0.5% (range - 16 to + 43%) at 6 months and - 4.00% (range - 42 to + 18%) at 24 months. Median DLCO variations versus baseline were - 1% (range - 38 to + 36%) at 6 months and - 12.2% (range - 48 to + 11%) at 24 months. At 6 months, a significant positive correlation emerged between FEV-1 change and KPS (p = 0.047). At 24 months, a significant negative correlation emerged between FEV-1 change and the ipsilateral lung V5 (p = 0.006). A low baseline DLCO correlated with more marked DLCO worsening at 6 months (p = 0.012). At 24 months, DLCO worsening correlated significantly with the median contralateral lung dose (p = 0.003). At the last checkup, 23 patients were in complete remission, 16 were in partial remission, 5 had stable disease, and 7 were in relapse. Median follow-up was 12 months (range 5-56). CONCLUSIONS: In patients with lung disease, SBRT, as delivered by HT, was well tolerated and provided good local control.
AIMS: This retrospective study reports outcomes after stereotactic body radiation therapy (SBRT) as delivered by helical tomotherapy (HT) for lung lesions. It promotes a dose escalation program. METHODS: Histological and/or radiological findings and/or case histories identified 41 primary and 15 metastatic lesions. Thirty patients received 40 Gy in 5 fractions (BED 72 Gy10Gy) and 26 50 Gy in 5 fractions (BED 100Gy10Gy). Primary end point was lung toxicity. Secondary end points were respiratory function, local control and local progression-free survival. RESULTS: Acute toxicity developed in 18/56 patients and late toxicity in 8/54. Median FEV-1 variations versus baseline were - 0.5% (range - 16 to + 43%) at 6 months and - 4.00% (range - 42 to + 18%) at 24 months. Median DLCO variations versus baseline were - 1% (range - 38 to + 36%) at 6 months and - 12.2% (range - 48 to + 11%) at 24 months. At 6 months, a significant positive correlation emerged between FEV-1 change and KPS (p = 0.047). At 24 months, a significant negative correlation emerged between FEV-1 change and the ipsilateral lung V5 (p = 0.006). A low baseline DLCO correlated with more marked DLCO worsening at 6 months (p = 0.012). At 24 months, DLCO worsening correlated significantly with the median contralateral lung dose (p = 0.003). At the last checkup, 23 patients were in complete remission, 16 were in partial remission, 5 had stable disease, and 7 were in relapse. Median follow-up was 12 months (range 5-56). CONCLUSIONS: In patients with lung disease, SBRT, as delivered by HT, was well tolerated and provided good local control.
Entities:
Keywords:
Lung; Respiratory function; Stereotactic body radiotherapy; Tomotherapy
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