Stereotactic body radiotherapy using gated radiotherapy with real-time tumor-tracking for stage I non-small cell lung cancer
Open Access
- 21 March 2013
- journal article
- Published by Springer Science and Business Media LLC in Radiation Oncology
- Vol. 8 (1), 69
- https://doi.org/10.1186/1748-717x-8-69
Abstract
Background: To clarify the clinical outcomes of two dose schedule of stereotactic body radiotherapy (SBRT) for stage I non-small cell lung cancer (NSCLC) using a real-time tumor-tracking radiation therapy (RTRT) system in single institution. Methods: Using a superposition algorithm, we administered 48 Gy in 4 fractions at the isocenter in 2005–2006 and 40 Gy in 4 fractions to the 95% volume of PTV in 2007–2010 with a treatment period of 4 to 7 days. Target volume margins were fixed irrespective of the tumor amplitude. Results: In total, 109 patients (79 T1N0M0 and 30 T2N0M0). With a median follow-up period of 25 months (range, 4 to 72 months), the 5-year local control rate (LC) was 78% and the 5-year overall survival rate (OS) was 64%. Grade 2, 3, 4, and 5 radiation pneumonitis (RP) was experienced by 15 (13.8%), 3 (2.8%), 0, and 0 patients, respectively. The mean lung dose (MLD) and the volume of lung receiving 20 Gy (V20) were significantly higher in patients with RP Grade 2/3 than in those with RP Grade 0/1 (MLD p = 0.002, V20 p = 0.003). There was no correlation between larger maximum amplitude of marker movement and larger PTV (r = 0.137), MLD (r = 0.046), or V20 (r = 0.158). Conclusions: SBRT using the RTRT system achieved LC and OS comparable to other SBRT studies with very low incidence of RP, which was consistent with the small MLD and V20 irrespective of tumor amplitude. For stage I NSCLC, SBRT using RTRT was suggested to be reliable and effective, especially for patients with large amplitude of tumor movement.Keywords
This publication has 43 references indexed in Scilit:
- Predicting Radiation Pneumonitis After Chemoradiation Therapy for Lung Cancer: An International Individual Patient Data Meta-analysisInternational Journal of Radiation Oncology*Biology*Physics, 2012
- Mediastinal lymph nodes staging by 18F-FDG PET/CT for early stage non-small cell lung cancer: A multicenter studyRadiotherapy and Oncology, 2012
- A Dose–Volume Analysis of Radiation Pneumonitis in Non–Small Cell Lung Cancer Patients Treated With Stereotactic Body Radiation TherapyInternational Journal of Radiation Oncology*Biology*Physics, 2012
- Real‐time 4‐D radiotherapy for lung cancerCancer Science, 2011
- Prognostic Factors in Stereotactic Body Radiotherapy for Non–Small-Cell Lung CancerInternational Journal of Radiation Oncology*Biology*Physics, 2011
- Stereotactic Body Radiotherapy for Medically Inoperable Lung Cancer: Prospective, Single-Center Study of 108 Consecutive PatientsInternational Journal of Radiation Oncology*Biology*Physics, 2011
- Stereotactic Body Radiotherapy (SBRT) for Operable Stage I Non–Small-Cell Lung Cancer: Can SBRT Be Comparable to Surgery?International Journal of Radiation Oncology*Biology*Physics, 2010
- Commissioning and quality assurance for a respiratory training system based on audiovisual biofeedback2010
- A Simple Respiratory Indicator for Irradiation during Voluntary Breath Holding: A One-Touch Device without Electronic MaterialsRadiology, 2010
- Prescreening based on the presence of CT-scan abnormalities and biomarkers (KL-6 and SP-D) may reduce severe radiation pneumonitis after stereotactic radiotherapyRadiation Oncology, 2010