Outcomes of Stereotactic Body Radiotherapy (SBRT) treatment of multiple synchronous and recurrent lung nodules
Autor: | Daniel J. Ma, Kathryn Nelson, Robert C. Miller, Yolanda I. Garces, Heather J. Bauer, Dawn Owen, Kenneth R. Olivier, Sean S. Park, Charles S. Mayo, Paul D. Brown |
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Jazyk: | angličtina |
Rok vydání: | 2015 |
Předmět: |
Adult
Male medicine.medical_specialty Pathology Lung Neoplasms medicine.medical_treatment Radiosurgery Young Adult Median follow-up medicine Humans Radiology Nuclear Medicine and imaging External beam radiotherapy Progression-free survival Prospective Studies Prospective cohort study Radiometry Survival rate Pneumonitis Aged Neoplasm Staging Aged 80 and over business.industry Research Radiotherapy Planning Computer-Assisted Mediastinum Radiotherapy Dosage Middle Aged medicine.disease Prognosis Radiation therapy Radiation Pneumonitis Survival Rate medicine.anatomical_structure Oncology Radiology Nuclear Medicine and imaging Female Radiology Radiotherapy Intensity-Modulated Neoplasm Recurrence Local business Follow-Up Studies |
Zdroj: | Radiation Oncology (London, England) |
ISSN: | 1748-717X |
Popis: | Background Stereotactic body radiotherapy (SBRT) is evolving into a standard of care for unresectable lung nodules. Local control has been shown to be in excess of 90% at 3 years. However, some patients present with synchronous lung nodules in the ipsilateral or contralateral lobe or metasynchronous disease. In these cases, patients may receive multiple courses of lung SBRT or a single course for synchronous nodules. The toxicity of such treatment is currently unknown. Methods Between 2006 and 2012, 63 subjects with 128 metasynchronous and synchronous lung nodules were treated at the Mayo Clinic with SBRT. Demographic patient data and dosimetric data regarding SBRT treatments were collected. Acute toxicity (defined as toxicity = 90 days) were reported and graded as per standardized CTCAE 4.0 criteria. Local control, progression free survival and overall survival were also described. Results The median age of patients treated was 73 years. Sixty five percent were primary or recurrent lung cancers with the remainder metastatic lung nodules of varying histologies. Of 63 patients, 18 had prior high dose external beam radiation to the mediastinum or chest. Dose and fractionation varied but the most common prescriptions were 48 Gy/4 fractions, 54 Gy/3 fractions, and 50 Gy/5 fractions. Only 6 patients demonstrated local recurrence. With a median follow up of 12.6 months, median SBRT specific overall survival and progression free survival were 35.7 months and 10.7 months respectively. Fifty one percent (32/63 patients) experienced acute toxicity, predominantly grade 1 and 2 fatigue. One patient developed acute grade 3 radiation pneumonitis at 75 days. Forty six percent (29/63 patients) developed late effects. Most were grade 1 dyspnea. There was one patient with grade 5 pneumonitis. Conclusion Multiple courses of SBRT and SBRT delivery after external beam radiotherapy appear to be feasible and safe. Most toxicity was grade 1 and 2 but the risk was approximately 50% for both acute and late effects. |
Databáze: | OpenAIRE |
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