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ID 115666
Title Alternative
SBRT FOR CENTRAL LUNG TUMORS WITH 56 Gy/7 fr
Author
Aoki, Shuri University of Tokyo
Yamashita, Hideomi University of Tokyo
Ota, Takeshi University of Tokyo
Takahashi, Wataru University of Tokyo
Ozaki, Sho University of Tokyo
Nawa, Kanabu University of Tokyo
Imae, Toshikazu University of Tokyo
Abe, Osamu University of Tokyo
Nakagawa, Keiichi University of Tokyo
Keywords
central lung tumor
stereotactic body radiotherapy
volumetric modulated arc therapy
lung cancer
radiation pneumonitis
pulmonary oligo‑recurrence
Content Type
Journal Article
Description
Stereotactic body radiotherapy (SBRT) for centrally‑located lung tumors remains a challenge because of the increased risk of treatment‑related adverse events (AEs), and uncertainty around prescribing the optimal dose. The present study reported the results of central tumor SBRT with 56 Gy in 7 fractions (fr) at the University of Tokyo Hospital. A total of 35 cases that underwent SBRT with or without volumetric‑modulated arc therapy consisting of 56 Gy/7 fr for central lung lesions between 2010 and 2016 at the University of Tokyo Hospital were reveiwed. A central lesion was defined as a tumor within 2 cm of the proximal bronchial tree (RTOG 0236 definition) or within 2 cm in all directions of any critical mediastinal structure. Local control (LC), overall survival (OS), and AEs were investigated. The Kaplan‑Meier method was used to estimate LC and OS. AEs were scored per the Common Terminology Criteria for Adverse Events Version 4.0. Thirty‑five patients with 36 central lung lesions were included. Fifteen lesions were primary non‑small cell lung cancer (NSCLC), 13 were recurrences of NSCLC, and 8 had oligo‑recurrences from other primaries. Median tumor diameter was 29 mm. Eighteen patients had had prior surgery. At a median follow‑up of 13.1 months for all patients and 18.3 months in surviving patients, 22 patients had died, ten due to primary disease (4 NSCLC), while three were treatment‑related. The 1‑ and 2‑year OS were 57.3 and 40.4%, respectively, and median OS was 15.7 months. Local recurrence occurred in only two lesions. 1‑ and 2‑year LC rates were both 96%. Nine patients experienced grade ≥3 toxicity, representing 26% of the cohort. Two of these were grade 5, one pneumonitis and one hemoptysis. Considering the background of the subject, tumor control of our central SBRT is promising, especially in primary NSCLC. However, the safety of SBRT to central lung cancer remains controversial.
Journal Title
Oncology Letters
ISSN
17921074
17921082
Publisher
Spandidos Publications
Volume
16
Issue
4
Start Page
4498
End Page
4506
Published Date
2018-07-23
Rights
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) License.(https://creativecommons.org/licenses/by-nc-nd/4.0/)
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DOI (Published Version)
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language
eng
TextVersion
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departments
Medical Sciences