Stereotactic body frame based fractionated radiosurgery on consecutive days for primary or metastatic tumors in the lung
To evaluate the feasibility and treatment outcomes of stereotactic radiosurgery (SRS) using a stereotactic body frame (Precision Therapy™), we prospectively reviewed 34 tumors of the 28 patients with primary or metastatic intrathoracic lung tumors. Eligible patients included were nine with primary l...
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Published in | Lung cancer (Amsterdam, Netherlands) Vol. 40; no. 3; pp. 309 - 315 |
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Main Authors | , , , , , , , , |
Format | Journal Article |
Language | English |
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01.06.2003
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Abstract | To evaluate the feasibility and treatment outcomes of stereotactic radiosurgery (SRS) using a stereotactic body frame (Precision Therapy™), we prospectively reviewed 34 tumors of the 28 patients with primary or metastatic intrathoracic lung tumors. Eligible patients included were nine with primary lung cancer and 19 with metastatic tumors from the lung, liver, and many other organs. A single dose of 10 Gy to the clinical target volume (CTV) was delivered to a total dose of 30–40 Gy with three to four fractions. Four to eight coplanar or non-coplanar static fields were generated to adequately cover the planning target volume (PTV) as well as to exclude the critical structures as much as possible. More than 90% of the PTV was delivered the prescribed dose in the majority of cases (average; 96%, range; 74–100%). The mean PTV was 41.4 cm
3 ranging from 4.4 to 230 cm
3. Set-up error was within 5 mm in all directions (
X,
Y,
Z axis). The response was evaluated by using a chest CT and/or
18FDG-PET scans after SRS treatment, 11 patients (39%) showed complete response, 12 (43%) partial response (decrease of more than 50% of the tumor volume), and four patients showed minimally decreased tumor volume or stable disease, but one patient showed progression disease. With a median follow-up period of 18 months, a local disease progression free interval was ranging from 7 to 35 months. Although all patients developed grade one radiation pneumonitis within 3 months, none had symptomatic or serious late complications after completing SRS treatment. Given these observations, it is concluded that the stereotactic body frame based SRS is a safe and effective treatment modality for the local management of primary or metastatic lung tumors. However, the optimum total dose and fractionation schedule used should be determined after the longer follow-up of these results. |
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AbstractList | To evaluate the feasibility and treatment outcomes of stereotactic radiosurgery (SRS) using a stereotactic body frame (Precision Therapy), we prospectively reviewed 34 tumors of the 28 patients with primary or metastatic intrathoracic lung tumors. Eligible patients included were nine with primary lung cancer and 19 with metastatic tumors from the lung, liver, and many other organs. A single dose of 10 Gy to the clinical target volume (CTV) was delivered to a total dose of 30-40 Gy with three to four fractions. Four to eight coplanar or non-coplanar static fields were generated to adequately cover the planning target volume (PTV) as well as to exclude the critical structures as much as possible. More than 90% of the PTV was delivered the prescribed dose in the majority of cases (average; 96%, range; 74-100%). The mean PTV was 41.4 cm(3) ranging from 4.4 to 230 cm(3). Set-up error was within 5 mm in all directions (X, Y, Z axis). The response was evaluated by using a chest CT and/or 18FDG-PET scans after SRS treatment, 11 patients (39%) showed complete response, 12 (43%) partial response (decrease of more than 50% of the tumor volume), and four patients showed minimally decreased tumor volume or stable disease, but one patient showed progression disease. With a median follow-up period of 18 months, a local disease progression free interval was ranging from 7 to 35 months. Although all patients developed grade one radiation pneumonitis within 3 months, none had symptomatic or serious late complications after completing SRS treatment. Given these observations, it is concluded that the stereotactic body frame based SRS is a safe and effective treatment modality for the local management of primary or metastatic lung tumors. However, the optimum total dose and fractionation schedule used should be determined after the longer follow-up of these results. To evaluate the feasibility and treatment outcomes of stereotactic radiosurgery (SRS) using a stereotactic body frame (Precision Therapy™), we prospectively reviewed 34 tumors of the 28 patients with primary or metastatic intrathoracic lung tumors. Eligible patients included were nine with primary lung cancer and 19 with metastatic tumors from the lung, liver, and many other organs. A single dose of 10 Gy to the clinical target volume (CTV) was delivered to a total dose of 30–40 Gy with three to four fractions. Four to eight coplanar or non-coplanar static fields were generated to adequately cover the planning target volume (PTV) as well as to exclude the critical structures as much as possible. More than 90% of the PTV was delivered the prescribed dose in the majority of cases (average; 96%, range; 74–100%). The mean PTV was 41.4 cm 3 ranging from 4.4 to 230 cm 3. Set-up error was within 5 mm in all directions ( X, Y, Z axis). The response was evaluated by using a chest CT and/or 18FDG-PET scans after SRS treatment, 11 patients (39%) showed complete response, 12 (43%) partial response (decrease of more than 50% of the tumor volume), and four patients showed minimally decreased tumor volume or stable disease, but one patient showed progression disease. With a median follow-up period of 18 months, a local disease progression free interval was ranging from 7 to 35 months. Although all patients developed grade one radiation pneumonitis within 3 months, none had symptomatic or serious late complications after completing SRS treatment. Given these observations, it is concluded that the stereotactic body frame based SRS is a safe and effective treatment modality for the local management of primary or metastatic lung tumors. However, the optimum total dose and fractionation schedule used should be determined after the longer follow-up of these results. |
Author | Yoon, Sang Min Park, Heon Joo Kim, Kyung Ju Choi, Eun Kyung Ahn, Seung Do Kim, Young Seok Lee, Sang-wook Kim, Jong Hoon Yi, Byong Yong |
Author_xml | – sequence: 1 givenname: Sang-wook surname: Lee fullname: Lee, Sang-wook organization: Department of Radiation Oncology, Asan Medical Center, College of Medicine, University of Ulsan, 388-1 Poongnap-Dong, Songpa-Gu, Seoul 138-736, South Korea – sequence: 2 givenname: Eun Kyung surname: Choi fullname: Choi, Eun Kyung email: ekchoi@amc.seoul.kr organization: Department of Radiation Oncology, Asan Medical Center, College of Medicine, University of Ulsan, 388-1 Poongnap-Dong, Songpa-Gu, Seoul 138-736, South Korea – sequence: 3 givenname: Heon Joo surname: Park fullname: Park, Heon Joo organization: Department of Microbiology, Inha University, Incheon, South Korea – sequence: 4 givenname: Seung Do surname: Ahn fullname: Ahn, Seung Do organization: Department of Radiation Oncology, Asan Medical Center, College of Medicine, University of Ulsan, 388-1 Poongnap-Dong, Songpa-Gu, Seoul 138-736, South Korea – sequence: 5 givenname: Jong Hoon surname: Kim fullname: Kim, Jong Hoon organization: Department of Radiation Oncology, Asan Medical Center, College of Medicine, University of Ulsan, 388-1 Poongnap-Dong, Songpa-Gu, Seoul 138-736, South Korea – sequence: 6 givenname: Kyung Ju surname: Kim fullname: Kim, Kyung Ju organization: Department of Radiation Oncology, Asan Medical Center, College of Medicine, University of Ulsan, 388-1 Poongnap-Dong, Songpa-Gu, Seoul 138-736, South Korea – sequence: 7 givenname: Sang Min surname: Yoon fullname: Yoon, Sang Min organization: Department of Radiation Oncology, Asan Medical Center, College of Medicine, University of Ulsan, 388-1 Poongnap-Dong, Songpa-Gu, Seoul 138-736, South Korea – sequence: 8 givenname: Young Seok surname: Kim fullname: Kim, Young Seok organization: Department of Radiation Oncology, Asan Medical Center, College of Medicine, University of Ulsan, 388-1 Poongnap-Dong, Songpa-Gu, Seoul 138-736, South Korea – sequence: 9 givenname: Byong Yong surname: Yi fullname: Yi, Byong Yong organization: Department of Radiation Oncology, Asan Medical Center, College of Medicine, University of Ulsan, 388-1 Poongnap-Dong, Songpa-Gu, Seoul 138-736, South Korea |
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Keywords | Stereotactic body frame Lung tumors Radiosurgery Human Lung disease Prognosis Respiratory disease Lung Metastasis Malignant tumor Bronchopulmonary Treatment Stereotaxic surgery Primary Bronchus disease Metastatic Lung tumor |
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Snippet | To evaluate the feasibility and treatment outcomes of stereotactic radiosurgery (SRS) using a stereotactic body frame (Precision Therapy™), we prospectively... To evaluate the feasibility and treatment outcomes of stereotactic radiosurgery (SRS) using a stereotactic body frame (Precision Therapy), we prospectively... |
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SubjectTerms | Adult Aged Aged, 80 and over Biological and medical sciences Dose Fractionation Female Fluorodeoxyglucose F18 Humans Lung Neoplasms - pathology Lung Neoplasms - secondary Lung Neoplasms - surgery Lung tumors Male Medical sciences Middle Aged Pneumology Radiosurgery Radiosurgery - adverse effects Radiosurgery - methods Stereotactic body frame Tomography, Emission-Computed Tomography, X-Ray Computed Treatment Outcome Tumors of the respiratory system and mediastinum |
Title | Stereotactic body frame based fractionated radiosurgery on consecutive days for primary or metastatic tumors in the lung |
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