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Radiation-Induced Secondary Cancer Risk Assessment in Patients With Lung Cancer After Stereotactic Body Radiotherapy Using the CyberKnife M6 System With Lung-Optimized Treatment

BACKGROUND: To evaluate the lifetime secondary cancer risk (SCR) of stereotactic body radiotherapy (SBRT) using the CyberKnife (CK) M6 system with a lung-optimized treatment (LOT) module for lung cancer patients. METHODS: We retrospectively enrolled 11 lung cancer patients curatively treated with SB...

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Autores principales: Chao, Pei-Ju, Tsai, I-Hsing, Huang, Chun-Chieh, Lin, Chih-Hsueh, Shieh, Chin-Shiuh, Hsieh, Yang-Wei, Yang, Pei-Ying, Lee, Hsiao-Fei, Lee, Tsair-Fwu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7223476/
https://www.ncbi.nlm.nih.gov/pubmed/32457880
http://dx.doi.org/10.3389/fbioe.2020.00306
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author Chao, Pei-Ju
Tsai, I-Hsing
Huang, Chun-Chieh
Lin, Chih-Hsueh
Shieh, Chin-Shiuh
Hsieh, Yang-Wei
Yang, Pei-Ying
Lee, Hsiao-Fei
Lee, Tsair-Fwu
author_facet Chao, Pei-Ju
Tsai, I-Hsing
Huang, Chun-Chieh
Lin, Chih-Hsueh
Shieh, Chin-Shiuh
Hsieh, Yang-Wei
Yang, Pei-Ying
Lee, Hsiao-Fei
Lee, Tsair-Fwu
author_sort Chao, Pei-Ju
collection PubMed
description BACKGROUND: To evaluate the lifetime secondary cancer risk (SCR) of stereotactic body radiotherapy (SBRT) using the CyberKnife (CK) M6 system with a lung-optimized treatment (LOT) module for lung cancer patients. METHODS: We retrospectively enrolled 11 lung cancer patients curatively treated with SBRT using the CK M6 robotic radiosurgery system. The planning treatment volume (PTV) and common organs at risk (OARs) for SCR analysis included the spinal cord, total lung, and healthy normal lung tissue (total lung volume - PTV). Schneider’s full model was used to calculate SCR according to the concept of organ equivalent dose (OED). RESULTS: CK-LOT-SBRT delivers precisely targeted radiation doses to lung cancers and achieves good PTV coverage and conformal dose distribution, thus posing limited SCR to surrounding tissues. The three OARs had similar risk equivalent dose (RED) values among four different models. However, for the PTV, differences in RED values were observed among the models. The cumulative excess absolute risk (EAR) value for the normal lung, spinal cord, and PTV was 70.47 (per 10,000 person-years). Schneider’s Lnt model seemed to overestimate the EAR/lifetime attributable risk (LAR). CONCLUSION: For lung cancer patients treated with CK-LOT optimized with the Monte Carlo algorithm, the SCR might be lower. Younger patients had a greater SCR, although the dose–response relationship seemed be non-linear for the investigated organs, especially with respect to the PTV. Despite the etiological association, the SCR after CK-LOT-SBRT for carcinoma and sarcoma, is low, but not equal to zero. Further research is required to understand and to show the lung SBRT SCR comparisons and differences across different modalities with motion management strategies.
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spelling pubmed-72234762020-05-25 Radiation-Induced Secondary Cancer Risk Assessment in Patients With Lung Cancer After Stereotactic Body Radiotherapy Using the CyberKnife M6 System With Lung-Optimized Treatment Chao, Pei-Ju Tsai, I-Hsing Huang, Chun-Chieh Lin, Chih-Hsueh Shieh, Chin-Shiuh Hsieh, Yang-Wei Yang, Pei-Ying Lee, Hsiao-Fei Lee, Tsair-Fwu Front Bioeng Biotechnol Bioengineering and Biotechnology BACKGROUND: To evaluate the lifetime secondary cancer risk (SCR) of stereotactic body radiotherapy (SBRT) using the CyberKnife (CK) M6 system with a lung-optimized treatment (LOT) module for lung cancer patients. METHODS: We retrospectively enrolled 11 lung cancer patients curatively treated with SBRT using the CK M6 robotic radiosurgery system. The planning treatment volume (PTV) and common organs at risk (OARs) for SCR analysis included the spinal cord, total lung, and healthy normal lung tissue (total lung volume - PTV). Schneider’s full model was used to calculate SCR according to the concept of organ equivalent dose (OED). RESULTS: CK-LOT-SBRT delivers precisely targeted radiation doses to lung cancers and achieves good PTV coverage and conformal dose distribution, thus posing limited SCR to surrounding tissues. The three OARs had similar risk equivalent dose (RED) values among four different models. However, for the PTV, differences in RED values were observed among the models. The cumulative excess absolute risk (EAR) value for the normal lung, spinal cord, and PTV was 70.47 (per 10,000 person-years). Schneider’s Lnt model seemed to overestimate the EAR/lifetime attributable risk (LAR). CONCLUSION: For lung cancer patients treated with CK-LOT optimized with the Monte Carlo algorithm, the SCR might be lower. Younger patients had a greater SCR, although the dose–response relationship seemed be non-linear for the investigated organs, especially with respect to the PTV. Despite the etiological association, the SCR after CK-LOT-SBRT for carcinoma and sarcoma, is low, but not equal to zero. Further research is required to understand and to show the lung SBRT SCR comparisons and differences across different modalities with motion management strategies. Frontiers Media S.A. 2020-05-07 /pmc/articles/PMC7223476/ /pubmed/32457880 http://dx.doi.org/10.3389/fbioe.2020.00306 Text en Copyright © 2020 Chao, Tsai, Huang, Lin, Shieh, Hsieh, Yang, Lee and Lee. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Bioengineering and Biotechnology
Chao, Pei-Ju
Tsai, I-Hsing
Huang, Chun-Chieh
Lin, Chih-Hsueh
Shieh, Chin-Shiuh
Hsieh, Yang-Wei
Yang, Pei-Ying
Lee, Hsiao-Fei
Lee, Tsair-Fwu
Radiation-Induced Secondary Cancer Risk Assessment in Patients With Lung Cancer After Stereotactic Body Radiotherapy Using the CyberKnife M6 System With Lung-Optimized Treatment
title Radiation-Induced Secondary Cancer Risk Assessment in Patients With Lung Cancer After Stereotactic Body Radiotherapy Using the CyberKnife M6 System With Lung-Optimized Treatment
title_full Radiation-Induced Secondary Cancer Risk Assessment in Patients With Lung Cancer After Stereotactic Body Radiotherapy Using the CyberKnife M6 System With Lung-Optimized Treatment
title_fullStr Radiation-Induced Secondary Cancer Risk Assessment in Patients With Lung Cancer After Stereotactic Body Radiotherapy Using the CyberKnife M6 System With Lung-Optimized Treatment
title_full_unstemmed Radiation-Induced Secondary Cancer Risk Assessment in Patients With Lung Cancer After Stereotactic Body Radiotherapy Using the CyberKnife M6 System With Lung-Optimized Treatment
title_short Radiation-Induced Secondary Cancer Risk Assessment in Patients With Lung Cancer After Stereotactic Body Radiotherapy Using the CyberKnife M6 System With Lung-Optimized Treatment
title_sort radiation-induced secondary cancer risk assessment in patients with lung cancer after stereotactic body radiotherapy using the cyberknife m6 system with lung-optimized treatment
topic Bioengineering and Biotechnology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7223476/
https://www.ncbi.nlm.nih.gov/pubmed/32457880
http://dx.doi.org/10.3389/fbioe.2020.00306
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