Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
Radiation Oncology
Published in: Radiation Oncology 1/2018

Open Access 01-12-2018 | Research

Stereotactic body radiotherapy for central lung tumors, yes we can!

Authors: Yasmin Korzets ceder, Eyal Fenig, Aron Popvtzer, Nir Peled, Mordechai R. Kramer, Milton Saute, Dima Bragilovsky, Tzippy Schochat, Aaron M. Allen

Published in: Radiation Oncology | Issue 1/2018

Login to get access

Abstract

Background

SBRT is standard therapy for early stage lung cancer. Toxicity in central tumors has been a concern. RTOG 0813 showed that central SBRT is safe and effective. We report our experience with central SBRT.

Methods

We reviewed the records of patients treated with SBRT for central lung tumors (< 2 cm of the carina). Patients included primary lung cancer and recurrence following surgery and\ or conventional radiotherapy. All patients underwent 4DCT simulation and treatment planning was done with IMRT or VMAT techniques. Dose to the PTV was prescribed to the 95% isodose line.

Results

Seventy patients, between 5/09 and 4/13, were treated. Patients had early non-small cell lung cancer (n = 13) or locally recurrent lung cancer (n = 29) and pulmonary oligometastases (n = 28). Fifty-seven percent of the patients received BED of 132 with a schedule of 60Gy in 12 Gy fractions. Median follow up time was 18.3 months, 4/70 patients experienced local failure (6%). Median OS for the whole cohort was 4.6 years (CI 3-7 years). Ten patients had grade 1-2 radiation pneumonitis. One patient developed fatal bronchial bleeding.

Conclusions

SBRT for central tumors is safe and effective in patients with central disease, reiradiation, recurrence following surgery and in oligometastes.
Literature
1.
Timmerman R, Mcgarry R, Yiannoutsos C, et al. Excessive toxicity when treating central tumors in a phase II study of stereotactic body radiation therapy in medically inoperable early stage lung cancer. J Clin Oncol. 2006;24:4833–9.CrossRefPubMed
2.
Song SY, Choi W, Shin SS, et al. Fractionated stereotactic body radiation therapy for medically inoperable stage I lung cancer adjacent to central large bronchus. Lung Cancer. 2009;66(1):89–93.CrossRefPubMed
3.
Rowe BP, Boffa DJ, Wilson LD, et al. Stereotactic body radiotherapy for central lung tumors. J Thorac Oncol. 2012;7(9):1394–9.CrossRefPubMed
4.
Bezjak A, Paulus R, Gaspar LE, et al. Primary study endpoint analysis for NRG oncology/RTOG 0813 trial of Stereotactic Body Radiation Therapy (SBRT) for centrally located Non-Small Cell Lung Cancer (NSCLC). Int J Radiat Biol Phys. 2016;94(1):5–6.CrossRef
5.
Sheu T, Heymach JV, Swisher SG, et al. Propensity score-matched analysis of comprehensive local therapy for oligometastatic non-small cell lung cancer that did not progress after front-line chemotherapy. Int J Radiat Oncol Biol Phys. 2014;90:850–7.CrossRefPubMed
6.
Hearn JW, Videtic GM, Djemil T, et al. Salvage stereotactic body radiation therapy (SBRT) for local failure after primary lung SBRT. Int J Radiat Oncol Biol Phys. 2014;90:402–6.CrossRefPubMed
7.
Kirkpatrick JP, Meyer JJ, Marks LB. The linear-quadratic model is inappropriate to model high dose per fraction effects in radiosurgery. Semin Radiat Oncol. 2008;18:240–3.CrossRefPubMed
8.
Timmerman RD, Hu C, Michalski J, et al. Long-term results of RTOG 0236: a phase II trial of Stereotactic Body Radiation Therapy (SBRT) in the treatment of patients with medically inoperable stage I non-small cell lung Cancer. Int J Radiat Biol Phys. 2014;90(1):S30.CrossRef
9.
Nuyttens JJ, Van der Voort van Zyp NC, Praag J, et al. Outcome of four dimentional stereotactic radiotherapy for centrally located lung tumors. Radiother Oncol. 2012;102:383–7.CrossRefPubMed
10.
Chang JY, Balter PA, Dong L, et al. Stereotactic body radiation therapy in centrally and superiorly located stage I or isolated recurrent non small cell ling cancer. Int J Radiat Biol Phys. 2008;72:967–71.CrossRef
11.
Chang YJ, Li QQ, Xu QY, et al. Stereotactic ablative radiation therapy for centrally located early stage or isolated parenchymal recurrences of non small cell lung cancer: how to fly in a “no fly zone”. Int J Radiat Biol Phys. 2014;88:1120–8.CrossRef
12.
Bwzjak A, Paulus R, Gaspar LE, et al. Primary study endpoint analysis for NRG oncology/RTOG 0813 trial of Stereotactic Body Radiation Therapy (SBRT) for centrally located Non-Small Cell Lung Cancer (NSCLC). Int J Radiat Biol Phys. 2016;96(2):S8.CrossRef
13.
14.
Bar J, Ng D, Moretto P, et al. Chemoradiotherapy for locoregional recurrence of non-small-cell lung cancer after surgical resection: a retrospective analysis. Clin Lung Cancer. 2013;14(2):200–4.CrossRefPubMed
15.
Kasprzyk M, Sławiński G, Musik M, et al. Completion pneumonectomy and chemoradiotherapy as treatment options in local recurrence of non-small-cell lung cancer. Kardiochir Torakochirurgia Pol. 2015;12(1):18–25.PubMedPubMedCentral
16.
Trovo M, Minatel E, Durofil E, et al. Stereotactic body radiation therapy for re-irradiation of persistent or recurrent non-small cell lung cancer. Int J Radiat Oncol Biol Phys. 2014;88:1114–9.CrossRefPubMed
17.
De Ruysscher D, Wanders R, van Baardwijk A, et al. Radical treatment of non-small-cell lung cancer patients with synchronous oligometastases: long-term results of a prospective phase II trial (Nct01282450). J Thorac Oncol. 2012;7:1547–55.CrossRefPubMed
18.
Wang J, Zhe J, Wang X, Liang J, et al. Radical thoracic radiotherapy may provide favorable outcomes for stage IV non-small cell lung cancer. Thorac Cancer. 2016;7(2):182–9.CrossRefPubMed
19.
Iyengar P, Kavanagh BD, Wardak Z, et al. Phase II trial of stereotactic body radiation therapy combined with erlotinib for patients with limited but progressive metastatic non–small-cell lung cancer. J Clin Oncol. 2014;32:3824–30.CrossRefPubMed
20.
Amini A, Yeh N, Gaspar LE, et al. Stereotactic Body Radiation Therapy (SBRT) for lung cancer patients previously treated with conventional radiotherapy: a review. Radiat Oncol. 2014;9:210.CrossRefPubMedPubMedCentral
Metadata
Title
Stereotactic body radiotherapy for central lung tumors, yes we can!
Authors
Yasmin Korzets ceder
Eyal Fenig
Aron Popvtzer
Nir Peled
Mordechai R. Kramer
Milton Saute
Dima Bragilovsky
Tzippy Schochat
Aaron M. Allen
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Radiation Oncology / Issue 1/2018
Electronic ISSN: 1748-717X
DOI
https://doi.org/10.1186/s13014-018-1017-y

Other articles of this Issue 1/2018

Radiation Oncology 1/2018 Go to the issue

Research

The dose distribution in dominant intraprostatic tumour lesions defined by multiparametric MRI and PSMA PET/CT correlates with the outcome in patients treated with primary radiation therapy for prostate cancer

Research

Comparison of treatment outcomes between squamous cell carcinoma and adenocarcinoma of cervix after definitive radiotherapy or concurrent chemoradiotherapy

Research

Identifying patterns of care for elderly patients with non-surgically treated stage III non-small cell lung cancer: an analysis of the national cancer database

Research

Dynamic changes in 18F-borono-L-phenylalanine uptake in unresectable, advanced, or recurrent squamous cell carcinoma of the head and neck and malignant melanoma during boron neutron capture therapy patient selection

Research

Optimization of training periods for the estimation model of three-dimensional target positions using an external respiratory surrogate

Research

DPM as a radiation transport engine for PRIMO