Stereotactic body radiotherapy using gated radiotherapy with real-time tumor-tracking for stage I non-small cell lung cancer

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• 作者：Tetsuya Inoue (1)
  Norio Katoh (1)
  Rikiya Onimaru (1)
  Shinichi Shimizu (1)
  Kazuhiko Tsuchiya (1)
  Ryusuke Suzuki (2)
  Jun Sakakibara-Konishi (3)
  Naofumi Shinagawa (3)
  Satoshi Oizumi (3)
  Hiroki Shirato (1)
  
• 关键词：Stereotactic body radiotherapy ; Radiation pneumonitis ; Non ; small cell lung cancer ; Real ; time tumor ; tracking ; Tumor motion ; Gated radiotherapy
• 刊名：Radiation Oncology
• 出版年：2013
• 出版时间：December 2013
• 年：2013
• 卷：8
• 期：1
• 全文大小：248KB
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• 作者单位：Tetsuya Inoue (1)
  Norio Katoh (1)
  Rikiya Onimaru (1)
  Shinichi Shimizu (1)
  Kazuhiko Tsuchiya (1)
  Ryusuke Suzuki (2)
  Jun Sakakibara-Konishi (3)
  Naofumi Shinagawa (3)
  Satoshi Oizumi (3)
  Hiroki Shirato (1)
  
  1. Department of Radiation Medicine, Hokkaido University Graduate School of Medicine, North 15 West 7, Kita-ku, Sapporo, 060-8638, Japan
  2. Department of Medical Physics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
  3. Department of Respiratory Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan
  

文摘

Background To clarify the clinical outcomes of two dose schedule of stereotactic body radiotherapy (SBRT) for stage I non-small cell lung cancer (NSCLC) using a real-time tumor-tracking radiation therapy (RTRT) system in single institution. Methods Using a superposition algorithm, we administered 48?Gy in 4 fractions at the isocenter in 2005-006 and 40?Gy in 4 fractions to the 95% volume of PTV in 2007-010 with a treatment period of 4 to 7?days. Target volume margins were fixed irrespective of the tumor amplitude. Results In total, 109 patients (79 T1N0M0 and 30 T2N0M0). With a median follow-up period of 25?months (range, 4 to 72?months), the 5-year local control rate (LC) was 78% and the 5-year overall survival rate (OS) was 64%. Grade 2, 3, 4, and 5 radiation pneumonitis (RP) was experienced by 15 (13.8%), 3 (2.8%), 0, and 0 patients, respectively. The mean lung dose (MLD) and the volume of lung receiving 20?Gy (V20) were significantly higher in patients with RP Grade 2/3 than in those with RP Grade 0/1 (MLD p--.002, V20 p--.003). There was no correlation between larger maximum amplitude of marker movement and larger PTV (r--.137), MLD (r--.046), or V20 (r--.158). Conclusions SBRT using the RTRT system achieved LC and OS comparable to other SBRT studies with very low incidence of RP, which was consistent with the small MLD and V20 irrespective of tumor amplitude. For stage I NSCLC, SBRT using RTRT was suggested to be reliable and effective, especially for patients with large amplitude of tumor movement.