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Clinical outcome of hypofractionated breath-hold image-guided SABR of primary lung tumors and lung metastases
BACKGROUND: Stereotactic Ablative RadioTherapy (SABR) of lung tumors/metastases has been shown to be an effective treatment modality with low toxicity. Outcome and toxicity were retrospectively evaluated in a unique single-institution cohort treated with intensity-modulated image-guided breath-hold...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3909294/ https://www.ncbi.nlm.nih.gov/pubmed/24401323 http://dx.doi.org/10.1186/1748-717X-9-10 |
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author | Boda-Heggemann, Judit Frauenfeld, Anian Weiss, Christel Simeonova, Anna Neumaier, Christian Siebenlist, Kerstin Attenberger, Ulrike Heußel, Claus Peter Schneider, Frank Wenz, Frederik Lohr, Frank |
author_facet | Boda-Heggemann, Judit Frauenfeld, Anian Weiss, Christel Simeonova, Anna Neumaier, Christian Siebenlist, Kerstin Attenberger, Ulrike Heußel, Claus Peter Schneider, Frank Wenz, Frederik Lohr, Frank |
author_sort | Boda-Heggemann, Judit |
collection | PubMed |
description | BACKGROUND: Stereotactic Ablative RadioTherapy (SABR) of lung tumors/metastases has been shown to be an effective treatment modality with low toxicity. Outcome and toxicity were retrospectively evaluated in a unique single-institution cohort treated with intensity-modulated image-guided breath-hold SABR (igSABR) without external immobilization. The dose–response relationship is analyzed based on Biologically Equivalent Dose (BED). PATIENTS AND METHODS: 50 lesions in 43 patients with primary NSCLC (n = 27) or lung-metastases of various primaries (n = 16) were consecutively treated with igSABR with Active-Breathing-Coordinator (ABC®) and repeat-breath-hold cone-beam-CT. After an initial dose-finding/-escalation period, 5x12 Gy for peripheral lesions and single doses of 5 Gy to varying dose levels for central lesions were applied. Overall-survival (OS), progression-free-survival (PFS), progression pattern, local control (LC) and toxicity were analyzed. RESULTS: The median BED2 was 83 Gy. 12 lesions were treated with a BED2 of <80 Gy, and 38 lesions with a BED2 of >80 Gy. Median follow-up was 15 months. Actuarial 1- and 2-year OS were 67% and 43%; respectively. Cause of death was non-disease-related in 27%. Actuarial 1- and 2-year PFS was 42% and 28%. Progression site was predominantly distant. Actuarial 1- and 2 year LC was 90% and 85%. LC showed a trend for a correlation to BED2 (p = 0.1167). Pneumonitis requiring conservative treatment occurred in 23%. CONCLUSION: Intensity-modulated breath-hold igSABR results in high LC-rates and low toxicity in this unfavorable patient cohort with inoperable lung tumors or metastases. A BED2 of <80 Gy was associated with reduced local control. |
format | Online Article Text |
id | pubmed-3909294 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-39092942014-02-02 Clinical outcome of hypofractionated breath-hold image-guided SABR of primary lung tumors and lung metastases Boda-Heggemann, Judit Frauenfeld, Anian Weiss, Christel Simeonova, Anna Neumaier, Christian Siebenlist, Kerstin Attenberger, Ulrike Heußel, Claus Peter Schneider, Frank Wenz, Frederik Lohr, Frank Radiat Oncol Research BACKGROUND: Stereotactic Ablative RadioTherapy (SABR) of lung tumors/metastases has been shown to be an effective treatment modality with low toxicity. Outcome and toxicity were retrospectively evaluated in a unique single-institution cohort treated with intensity-modulated image-guided breath-hold SABR (igSABR) without external immobilization. The dose–response relationship is analyzed based on Biologically Equivalent Dose (BED). PATIENTS AND METHODS: 50 lesions in 43 patients with primary NSCLC (n = 27) or lung-metastases of various primaries (n = 16) were consecutively treated with igSABR with Active-Breathing-Coordinator (ABC®) and repeat-breath-hold cone-beam-CT. After an initial dose-finding/-escalation period, 5x12 Gy for peripheral lesions and single doses of 5 Gy to varying dose levels for central lesions were applied. Overall-survival (OS), progression-free-survival (PFS), progression pattern, local control (LC) and toxicity were analyzed. RESULTS: The median BED2 was 83 Gy. 12 lesions were treated with a BED2 of <80 Gy, and 38 lesions with a BED2 of >80 Gy. Median follow-up was 15 months. Actuarial 1- and 2-year OS were 67% and 43%; respectively. Cause of death was non-disease-related in 27%. Actuarial 1- and 2-year PFS was 42% and 28%. Progression site was predominantly distant. Actuarial 1- and 2 year LC was 90% and 85%. LC showed a trend for a correlation to BED2 (p = 0.1167). Pneumonitis requiring conservative treatment occurred in 23%. CONCLUSION: Intensity-modulated breath-hold igSABR results in high LC-rates and low toxicity in this unfavorable patient cohort with inoperable lung tumors or metastases. A BED2 of <80 Gy was associated with reduced local control. BioMed Central 2014-01-08 /pmc/articles/PMC3909294/ /pubmed/24401323 http://dx.doi.org/10.1186/1748-717X-9-10 Text en Copyright © 2014 Boda-Heggemann et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Boda-Heggemann, Judit Frauenfeld, Anian Weiss, Christel Simeonova, Anna Neumaier, Christian Siebenlist, Kerstin Attenberger, Ulrike Heußel, Claus Peter Schneider, Frank Wenz, Frederik Lohr, Frank Clinical outcome of hypofractionated breath-hold image-guided SABR of primary lung tumors and lung metastases |
title | Clinical outcome of hypofractionated breath-hold image-guided SABR of primary lung tumors and lung metastases |
title_full | Clinical outcome of hypofractionated breath-hold image-guided SABR of primary lung tumors and lung metastases |
title_fullStr | Clinical outcome of hypofractionated breath-hold image-guided SABR of primary lung tumors and lung metastases |
title_full_unstemmed | Clinical outcome of hypofractionated breath-hold image-guided SABR of primary lung tumors and lung metastases |
title_short | Clinical outcome of hypofractionated breath-hold image-guided SABR of primary lung tumors and lung metastases |
title_sort | clinical outcome of hypofractionated breath-hold image-guided sabr of primary lung tumors and lung metastases |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3909294/ https://www.ncbi.nlm.nih.gov/pubmed/24401323 http://dx.doi.org/10.1186/1748-717X-9-10 |
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