SUNSET: Stereotactic Radiation for Ultracentral Non-Small-Cell Lung Cancer-A Safety and Efficacy Trial
| Autor: | Meredith Giuliani, Anand Swaminath, Houda Bahig, Ashwathy Susan Mathew, Vivian Yau, Edith Filion, Daniel Glick, Alexander V. Louie, Scott V. Bratman, Srinivas Raman, David A. Palma, Andrew Warner |
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| Rok vydání: | 2018 |
| Předmět: |
Pulmonary and Respiratory Medicine
Cancer Research medicine.medical_specialty Lung Neoplasms Maximum Tolerated Dose medicine.medical_treatment Radiosurgery 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Carcinoma Non-Small-Cell Lung Medicine Humans Esophagus Stage (cooking) Lung cancer Lung business.industry Bronchial Stricture Cancer Radiotherapy Dosage medicine.disease Radiation therapy Regimen medicine.anatomical_structure Oncology Research Design 030220 oncology & carcinogenesis Radiology Dose Fractionation Radiation business |
| Zdroj: | Clinical lung cancer. 19(4) |
| ISSN: | 1938-0690 |
| Popis: | Background Lung stereotactic body radiotherapy (SBRT) is considered a standard curative treatment for medically inoperable early stage non–small-cell lung cancer (NSCLC). Patients with ultracentral tumors (signifying tumors whose planning target volume touches or overlaps the central bronchial tree, esophagus, or pulmonary artery) may be at higher risk of serious toxicities such as bronchial stricture and collapse, esophageal strictures, tracheal–esophageal fistula, and hemorrhage. The primary objective of the study is to determine the maximum tolerated dose of radiotherapy for ultracentral NSCLC. Methods This multicenter phase 1 dose-escalation study will use a time-to-event continual reassessment method (TITE-CRM). Accrual will start at level 1 (60 Gy in 8 fractions delivered daily). The model will use all available information from previously accrued patients to assign the highest dose with a predicted risk of grade 3-5 toxicity of 30% or less. All patients with newly diagnosed stage T1-3 N0M0 NSCLC (International Union Against Cancer, 8th edition) with tumor size ≤ 6 cm and meeting the criteria for ultracentral location (ie, tumors whose planning target volume touches or overlaps the central bronchial tree, esophagus, pulmonary vein, or pulmonary artery) will be eligible for this study. Discussion It is important to identify a safe dose-fractionation regimen for treating ultracentral tumors with SBRT. In addition, the data from this study may be informative in guiding future studies on the use of SBRT in treating malignancies within the mediastinum—for example, for salvage treatment of mediastinal lymph nodes for recurrent NSCLC or mediastinal oligometastases. |
| Databáze: | OpenAIRE |
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