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Stereotactic Body Radiotherapy (SBRT) for High-risk Central Pulmonary Metastases

Overview
Journal Radiat Oncol
Publisher Biomed Central
Specialties Oncology
Radiology
Date 2016 Feb 28
PMID 26920142
Citations 21
Authors
Affiliations
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Abstract

Background And Purpose: Radiotherapy of central lung tumors carries a higher risk of treatment-related toxicity and local failure. In the era of aggressive oligometastic management the exploration of the proper dose-fractionation for metastatic central lung tumors is essential.

Materials And Methods: Patients diagnosed with high-risk metastatic lesions of the central pulmonary tree comprised this single-institutional retrospective analysis. "High-risk" central pulmonary lesions were defined as those with abutment and/or invasion of the mainstem bronchus. All patients were treated using the CyberKnife SBRT system in 5 fractions to a total dose of 35 or 40 Gy.

Results: Twenty patients were treated from 2008 to 2011 at Georgetown University Hospital. At a median follow up of 19 months, 1-year Kaplan-Meier local control and overall survival was 70 and 75 %, respectively. Late grade 2 or higher atelectasis was the most common treatment-related toxicity and was significantly associated with maximum dose to the mainstem bronchus. Gross endobronchial involvement was associated with significantly lower overall survival.

Conclusions: Five-fraction SBRT to a total dose of 35 or 40 Gy appears to be a safe and effective management strategy for high-risk central pulmonary metastatic lesions, though care should be taken to limit the maximum point dose to the mainstem bronchus.

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References
1.
Mangona V, Aneese A, Marina O, Hymas R, Ionascu D, Robertson J . Toxicity after central versus peripheral lung stereotactic body radiation therapy: a propensity score matched-pair analysis. Int J Radiat Oncol Biol Phys. 2014; 91(1):124-32. DOI: 10.1016/j.ijrobp.2014.08.345. View

2.
Heitmiller R, Marasco W, Hruban R, Marsh B . Endobronchial metastasis. J Thorac Cardiovasc Surg. 1993; 106(3):537-42. View

3.
Pastorino U, Buyse M, Friedel G, Ginsberg R, Girard P, Goldstraw P . Long-term results of lung metastasectomy: prognostic analyses based on 5206 cases. J Thorac Cardiovasc Surg. 1997; 113(1):37-49. DOI: 10.1016/s0022-5223(97)70397-0. View

4.
Timmerman R, Paulus R, Galvin J, Michalski J, Straube W, Bradley J . Stereotactic body radiation therapy for inoperable early stage lung cancer. JAMA. 2010; 303(11):1070-6. PMC: 2907644. DOI: 10.1001/jama.2010.261. View

5.
Kang K, Okoye C, Patel R, Siva S, Biswas T, Ellis R . Complications from Stereotactic Body Radiotherapy for Lung Cancer. Cancers (Basel). 2015; 7(2):981-1004. PMC: 4491695. DOI: 10.3390/cancers7020820. View