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
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Radiation Oncology
Published in: Radiation Oncology 1/2016

Open Access 01-12-2016 | Research

Stereotactic body radiotherapy (SBRT) for high-risk central pulmonary metastases

Authors: Jonathan W. Lischalk, Ryan M. Malik, Sean P. Collins, Brian T. Collins, Ismael A. Matus, Eric D. Anderson

Published in: Radiation Oncology | Issue 1/2016

Login to get access

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.
Literature
1.
Corbin KS, Hellman S, Weichselbaum RR. Extracranial oligometastases: a subset of metastases curable with stereotactic radiotherapy. J Clin Oncol Off J Am Soc Clin Oncol. 2013;31(11):1384–90.CrossRef
2.
Palma DA, Haasbeek CJ, Rodrigues GB, Dahele M, Lock M, Yaremko B, et al. Stereotactic ablative radiotherapy for comprehensive treatment of oligometastatic tumors (SABR-COMET): study protocol for a randomized phase II trial. BMC Cancer. 2012;12:305.PubMedCentralCrossRefPubMed
3.
Pastorino U, Buyse M, Friedel G, Ginsberg RJ, Girard P, Goldstraw P, et al. Long-term results of lung metastasectomy: prognostic analyses based on 5206 cases. J Thorac Cardiovasc Surg. 1997;113(1):37–49.CrossRefPubMed
4.
Okunieff P, Petersen AL, Philip A, Milano MT, Katz AW, Boros L, et al. Stereotactic Body Radiation Therapy (SBRT) for lung metastases. Acta Oncol. 2006;45(7):808–17.CrossRefPubMed
5.
Timmerman R, McGarry R, Yiannoutsos C, Papiez L, Tudor K, DeLuca J, et al. Excessive toxicity when treating central tumors in a phase II study of stereotactic body radiation therapy for medically inoperable early-stage lung cancer. J Clin Oncol Off J Am Soc Clin Oncol. 2006;24(30):4833–9.CrossRef
6.
Rowe BP, Boffa DJ, Wilson LD, Kim AW, Detterbeck FC, Decker RH. Stereotactic body radiotherapy for central lung tumors. J Thorac Oncol. 2012;7(9):1394–9.CrossRefPubMed
7.
Oshiro Y, Aruga T, Tsuboi K, Marino K, Hara R, Sanayama Y, et al. Stereotactic body radiotherapy for lung tumors at the pulmonary hilum. Strahlenther Onkol. 2010;186(5):274–9.CrossRefPubMed
8.
Kang KH, Okoye CC, Patel RB, Siva S, Biswas T, Ellis RJ, et al. Complications from stereotactic body radiotherapy for lung cancer. Cancers. 2015;7(2):981–1004.PubMedCentralCrossRefPubMed
9.
Adebahr S, Collette S, Shash E, Lambrecht M, Le Pechoux C, Faivre-Finn C, et al. LungTech, an EORTC Phase II trial of stereotactic body radiotherapy for centrally located lung tumours: a clinical perspective. Br J Radiol. 2015;88(1051):20150036.CrossRefPubMed
10.
Timmerman R, Paulus R, Galvin J, Michalski J, Straube W, Bradley J, et al. Stereotactic body radiation therapy for inoperable early stage lung cancer. JAMA. 2010;303(11):1070–6.PubMedCentralCrossRefPubMed
11.
Joyner M, Salter BJ, Papanikolaou N, Fuss M. Stereotactic body radiation therapy for centrally located lung lesions. Acta Oncol. 2006;45(7):802–7.CrossRefPubMed
12.
Haseltine JM, Rimner A, Gelblum DY, Modh A, Rosenzweig KE, Jackson A, et al. Fatal complications after stereotactic body radiation therapy for central lung tumors abutting the proximal bronchial tree. Pract Radiat Oncol. 2015 Nov 11. pii: S1879-8500(15)00319-7. doi:10.​1016/​j.​prro.​2015.​09.​012. [Epub ahead of print].
13.
Chaudhuri AA, Tang C, Binkley MS, Jin M, Wynne JF, von Eyben R, et al. Stereotactic ablative radiotherapy (SABR) for treatment of central and ultra-central lung tumors. Lung Cancer. 2015;89(1):50–6.CrossRefPubMed
14.
Navarria P, Ascolese AM, Tomatis S, Cozzi L, De Rose F, Mancosu P, et al. Stereotactic body radiotherapy (sbrt) in lung oligometastatic patients: role of local treatments. Radiat Oncol. 2014;9(1):91.PubMedCentralCrossRefPubMed
15.
Unger K, Ju A, Oermann E, Suy S, Yu X, Vahdat S, et al. CyberKnife for hilar lung tumors: report of clinical response and toxicity. J Hematol Oncol. 2010;3:39.PubMedCentralCrossRefPubMed
16.
Collins BT, Erickson K, Reichner CA, Collins SP, Gagnon GJ, Dieterich S, et al. Radical stereotactic radiosurgery with real-time tumor motion tracking in the treatment of small peripheral lung tumors. Radiat Oncol. 2007;2:39.PubMedCentralCrossRefPubMed
17.
Ricardi U, Filippi AR, Guarneri A, Ragona R, Mantovani C, Giglioli F, et al. Stereotactic body radiation therapy for lung metastases. Lung Cancer. 2012;75(1):77–81.CrossRefPubMed
18.
Baumann P, Nyman J, Lax I, Friesland S, Hoyer M, Rehn Ericsson S, et al. Factors important for efficacy of stereotactic body radiotherapy of medically inoperable stage I lung cancer. A retrospective analysis of patients treated in the Nordic countries. Acta Oncol. 2006;45(7):787–95.CrossRefPubMed
19.
Mangona VS, Aneese AM, Marina O, Hymas RV, Ionascu D, Robertson JM, et al. Toxicity after central versus peripheral lung stereotactic body radiation therapy: a propensity score matched-pair analysis. Int J Radiat Oncol Biol Phys. 2015;91(1):124–32.CrossRefPubMed
20.
Park HS, Harder EM, Mancini BR, Decker RH. Central versus peripheral tumor location: influence on survival, local control, and toxicity following stereotactic body radiotherapy for primary Non-small-cell lung cancer. J Thorac Oncol. 2015;10(5):832–7.CrossRefPubMed
21.
Davis JN, Medbery C, Sharma S, Pablo J, Kimsey F, Perry D, et al. Stereotactic body radiotherapy for centrally located early-stage non-small cell lung cancer or lung metastases from the RSSearch((R)) patient registry. Radiat Oncol. 2015;10:113.PubMedCentralCrossRefPubMed
22.
Hamamoto Y, Kataoka M, Yamashita M, Shinkai T, Kubo Y, Sugawara Y, et al. Local control of metastatic lung tumors treated with SBRT of 48 Gy in four fractions: in comparison with primary lung cancer. Jpn J Clin Oncol. 2010;40(2):125–9.CrossRefPubMed
23.
Milano MT, Chen Y, Katz AW, Philip A, Schell MC, Okunieff P. Central thoracic lesions treated with hypofractionated stereotactic body radiotherapy. Radiother Oncol. 2009;91(3):301–6.CrossRefPubMed
24.
Singh D, Chen Y, Hare MZ, Usuki KY, Zhang H, Lundquist T, et al. Local control rates with five-fraction stereotactic body radiotherapy for oligometastatic cancer to the lung. J Thorac Dis. 2014;6(4):369–74.PubMedCentralPubMed
25.
Schanne DH, Nestle U, Allgauer M, Andratschke N, Appold S, Dieckmann U, et al. Stereotactic body radiotherapy for centrally located stage I NSCLC: a multicenter analysis. Strahlenther Onkol. 2015;191(2):125–32.CrossRefPubMed
26.
Heitmiller RF, Marasco WJ, Hruban RH, Marsh BR. Endobronchial metastasis. J Thorac Cardiovasc Surg. 1993;106(3):537–42.PubMed
27.
28.
Coriat R, Diaz O, de la Fouchardiere C, Desseigne F, Negrier S. Endobronchial metastases from colorectal adenocarcinomas: clinical and endoscopic characteristics and patient prognosis. Oncology. 2007;73(5–6):395–400.CrossRefPubMed
29.
Katsimbri PP, Bamias AT, Froudarakis ME, Peponis IA, Constantopoulos SH, Pavlidis NA. Endobronchial metastases secondary to solid tumors: report of eight cases and review of the literature. Lung Cancer. 2000;28(2):163–70.CrossRefPubMed
Metadata
Title
Stereotactic body radiotherapy (SBRT) for high-risk central pulmonary metastases
Authors
Jonathan W. Lischalk
Ryan M. Malik
Sean P. Collins
Brian T. Collins
Ismael A. Matus
Eric D. Anderson
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Radiation Oncology / Issue 1/2016
Electronic ISSN: 1748-717X
DOI
https://doi.org/10.1186/s13014-016-0608-8

Other articles of this Issue 1/2016

Radiation Oncology 1/2016 Go to the issue

Research

Worst case optimization for interfractional motion mitigation in carbon ion therapy of pancreatic cancer

Research

Consolidation chemotherapy during neoadjuvant chemoradiation (CRT) for distal rectal cancer leads to sustained decrease in tumor metabolism when compared to standard CRT regimen

Research

Acute toxicity in comprehensive head and neck radiation for nasopharynx and paranasal sinus cancers: cohort comparison of 3D conformal proton therapy and intensity modulated radiation therapy

Erratum

Erratum to: Low-dose brachytherapy for early stage penile cancer: a 20-year single-institution study (73 patients)

Research

To gate or not to gate - dosimetric evaluation comparing Gated vs. ITV-based methodologies in stereotactic ablative body radiotherapy (SABR) treatment of lung cancer

Research

Titanium peroxide nanoparticles enhanced cytotoxic effects of X-ray irradiation against pancreatic cancer model through reactive oxygen species generation in vitro and in vivo