Dose coverage impacts local control in ultra-central lung oligometastases treated with stereotactic radiotherapy.
Strahlenther Onkol
; 197(5): 396-404, 2021 May.
Article
em En
| MEDLINE
| ID: mdl-32970163
ABSTRACT
INTRODUCTION:
The use of Stereotactic Body Radiotherapy (SBRT) is controversial in Ultra-Central lung tumors, a subset of central lung tumors characterized by proximity to critical mediastinal structures. This is of interest in oligometastatic (≤3 metastases) patients, who can yield survival benefit from local treatments. The aim of our study is to assess the determinants of efficacy and toxicity in this setting. MATERIALS ANDMETHODS:
Clinical and dosimetric parameters were reviewed in a cohort of oligometastatic patients treated with SBRT for ultra-central tumors. Local control rate (LC) and toxicity were assessed. Statistical Analysis was carried out to assess the impact of those predictors on local recurrence and adverse events.RESULTS:
One-hundred-nine consecutive patients were included. A median Biologic Effective Dose (BED) of 105 (75-132) Gy10 was prescribed. At a median follow-up of 17 (range 3-78) months, 2-year LC was 87%. Improved LC was correlated to Planning Treatment Volume (PTV) covered by 95% of the prescription dose (V95% PTV) > 85% (HR 0.15, 95%CI 0.05-0.49, pâ¯= 0.0017) and to Gross Tumor Volume (GTV) < 90â¯cm3 (HR 0.2, 95%CI 0.07-0.56, pâ¯= 0.0021). Overall and grade ≥â¯3 toxicity incidence was 20% and 5%, respectively. Patients experiencing acute and late toxicities received significantly higher dose to 1â¯cm3 (D1cm3) of esophagus and lung volume receiving ≥5â¯Gy (V5Gy) (pâ¯= 0.016 and pâ¯= 0.013), and higher dose to 0.1â¯cm3 (D0.1cm3) of heart (pâ¯= 0.036), respectively.CONCLUSION:
V95% PTV >â¯85% and GTV <â¯90â¯cm3 are independent predictors of LC. Dose to esophagus, lung and heart should be carefully assessed to minimize treatment-related toxicities.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Radiocirurgia
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Neoplasias Pulmonares
Tipo de estudo:
Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Strahlenther Onkol
Assunto da revista:
NEOPLASIAS
/
RADIOTERAPIA
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Itália