Hypofraktionierte stereotaktische Radiotherapie primärer und sekundärer Lungentumoren. Präliminäre Ergebnisse einer Phase-I/II-Studie

Abstract

To evaluate the feasibility, efficacy, and side effects of dose escalation in hypofractionated stereotactic radiotherapy (hfSRT) for intrapulmonary tumors with the Novalis™ system (BrainLAB AG, Heimstetten, Germany). From 07/2003 to 01/2005, 21 patients/39 tumors were treated with 5 × 7 Gy (n = 21; total dose 35 Gy) or 5 × 8 Gy (n = 18; total dose 40 Gy). There were three cases of primary lung cancer, the remainder were metastases. Median gross tumor volume (GTV) and planning target volume (PTV) were 2.89 cm³ (range, 0.15–67.94 cm³) and 25.75 cm³ (range, 7.18–124.04 cm³), respectively. Rates of complete remission, partial remission, no change, and progressive disease were 51%, 33%, 3%, and 13%, respectively. No grade 4 toxicity occurred, nearly all patients had grade 1 initially. One grade 3 toxicity, i.e., dyspnea, was documented for a period of 6 months after therapy. Radiosurgery quality assurance guidelines could be met. hfSRT of primary and secondary lung tumors using a schedule of five fractions at 7–8 Gy each was well tolerated. Further dose escalation is planned.