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Radiation Oncology
Published in: Radiation Oncology 1/2017

Open Access 01-12-2017 | Research

Predictors of chest wall toxicity after stereotactic ablative radiotherapy using real-time tumor tracking for lung tumors

Authors: Younghee Park, Hee Jung Kim, Ah Ram Chang

Published in: Radiation Oncology | Issue 1/2017

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Abstract

Background

To evaluate the incidence of chest wall toxicity after lung stereotactic ablative radiotherapy (SABR) and identify risk factors for the development of rib fracture.

Methods

Thirty-nine patients with 49 lesions underwent SABR for primary or metastatic lung tumors using Cyberknife® with tumor tracking systems. Patient characteristics, treatment factors and variables obtained from dose-volume histograms (DVHs) were analyzed to find the association with chest wall toxicity. Four-dimensional (4D) dose calculations were done to investigate the effect of respiratory motion on dose to the ribs.

Results

After follow-up of median 26.7 months (range: 8.4 – 80.0), 8 patients (20.5%) experienced rib fractures and among these patients, three (37.5%) had chest wall pain at 2–3 months after SABR. Median time to rib fracture was 13.4 months (range: 8.0 – 38.5) and the 2-year actuarial risk of rib fracture was 12.2%. Dose to the 4.6 cc of the ribs (D4.6cc) and rib volume received 160 Gy or more (V160) were significant predictor for rib fracture. No significant differences between three-dimensional (3D) and 4D dose calculations were found.

Conclusions

Parameters from DVH are useful in predicting the risk of chest wall toxicity after SABR for lung tumors. Efforts should be made to reduce the risk of the rib fracture after lung SABR.
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Metadata
Title
Predictors of chest wall toxicity after stereotactic ablative radiotherapy using real-time tumor tracking for lung tumors
Authors
Younghee Park
Hee Jung Kim
Ah Ram Chang
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Radiation Oncology / Issue 1/2017
Electronic ISSN: 1748-717X
DOI
https://doi.org/10.1186/s13014-017-0803-2

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