DART-bid: dose-differentiated accelerated radiation therapy, 1.8 Gy twice daily

Zehentmayr, Franz; Wurstbauer, Karl; Deutschmann, H.; Fussl, Christoph; Kopp, Peter; Dagn, Karin; Fastner, Gerd; Porsch, Peter; Studnicka, Michael; Sedlmayer, Felix

doi:10.1007/s00066-014-0754-6

Cited by 9 publications

(2 citation statements)

References 39 publications

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“…In total, 31 studies were identified, which fulfilled the selection criteria, Of those, 8 studies report outcomes after conventionally fractionated treatments of a total of 344 patients [ 30 – 37 ] and 23 studies including 1975 patients reporting on hypofractionated irradiations [ 38 – 60 ]. A total of 34 local control - schedule data points, with doses per fraction ranging from 30 to 1.2 Gy, applied in 1–58 fractions, were collected (see Tables 1 and 2 , and Additional file 1 for details of the publication search).…”

Section: Resultsmentioning

confidence: 99%

Challenges in radiobiological modeling: can we decide between LQ and LQ-L models based on reviewed clinical NSCLC treatment outcome data?

et al. 2016

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AimTo study the dose-response of stage I non-small-cell lung cancer (NSCLC) in terms of long-term local tumor control (LC) after conventional and hypofractionated photon radiotherapy, modeled with the linear-quadratic (LQ) and linear-quadratic-linear (LQ-L) approaches and to estimate the clinical α/β ratio within the LQ frame.Material and methodsWe identified studies of curative radiotherapy as single treatment through MedLine search reporting 3-year LC as primary outcome of interest. Logistic models coupled with the biologically effective dose (BED) at isocenter and PTV edge according to both the LQ and LQ-L models with α/β = 10 Gy were fitted. Additionally, α/β was estimated from direct LQ fits.ResultsThirty one studies were included reporting outcome of 2319 patients. The LQ-L fit yielded a significant value of 11.0 ± 5.2 Gy for the dose threshold (Dt) for BED10 at the isocenter. The LQ and LQ-L fits did not differ substantially. Concerning the estimation of α/β, the value obtained from the direct LQ fit for the complete fractionation range was 3.9 [68 % CI: 2.2–9.0] Gy (p > 0.05).ConclusionBoth LQ and LQ-L fits can model local tumor control after conventionally and hypofractionated irradiation and are robust methods for predicting clinical effects. The observed dose-effect for local control in NSCLC is weaker at high doses due to data dispersion. For BED10 values of 100–150 Gy in ≥3 fractions, the differences in isoeffects predicted by both models can be neglected.Electronic supplementary materialThe online version of this article (doi:10.1186/s13014-016-0643-5) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Challenges in radiobiological modeling: can we decide between LQ and LQ-L models based on reviewed clinical NSCLC treatment outcome data?

et al. 2016

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“…[ 3 , 31 ] The improvements of radiation technology and radiation accuracy offer dose escalation as well as normal tissue sparing. [ 32 , 33 ] However, the results of Radiation Therapy Oncology Group (RTOG) 0617, which compared 74 Gy with the standard 60 Gy both delivered with concurrent chemotherapy, founded the high-dose arm had worse OS compared with standard-dose arm. [ 11 ] Meanwhile, the RTOG0617 founded that heart V5 and heart V30 were predictors of overall survival on multivariate models.…”

Section: Discussionmentioning

confidence: 99%

Heart dose linked with cardiac events and overall survival in lung cancer radiotherapy

et al. 2020

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Background: The aim of this study was to investigate the link between heart dose and overall survival, the link between heart dose and cardiac events and whether radiation-induced heart diseases were associated with overall survival in lung cancer radiotherapy. Methods: We performed a literature search by using Pubmed, Embase, China National Knowledge Infrastructure (CNKI) databases. Pairs of reviewers independently screened literature according to the inclusion criteria, extracted data, assessed methodological quality, and publication bias. The primary end points included overall survival and cardiac events. I 2 was calculated in a heterogeneity assessment. Publication bias was evaluated by using Begg funnel plot and Egger test. Results: Ten studies including 1 randomized controlled trial, 3 post hoc analysis of prospective trials, and 6 cohort studies were identified. The meta-analysis showed that heart volume receiving ≥5 Gy (HV5) (hazard ratio [HR] = 1.01; 95% confidence interval [CI]: 1.00–1.01), heart volume receiving ≥30 Gy (HV30) (HR = 1.01; 95% CI: 1.00–1.02), heart volume receiving ≥50 Gy (HV50) (HR = 1.05; 95%CI: 1.00–1.10), and mean heart dose (MHD) (HR = 1.01; 95%CI:1.00–1.02) all were associated with worse overall survival. In addition, the MHD (HR = 1.03; 95% CI: 1.02–1.05), HV5 (HR = 1.02; 95% CI: 1.01–1.03), and HV30 (HR = 1.02; 95% CI: 1.01–1.03) were significantly associated with all grade cardiac events. Meanwhile, compared with those who did not receive radiotherapy, the radiotherapy group experienced a significantly increased risk for cardiac-specific mortality (HR = 1.297; 95% CI: 1.213–1.387). However, the results did not show that cardiac events were associated with overall survival in lung cancer radiotherapy (HR = 1.472; 95% CI: 0.988–2.193). Conclusion: Exposure of the heart to radiation increased the risk of cardiac events during radiotherapy for lung cancer. Meanwhile, heart dose including HV5 and HV30 were predictors of overall survival in lung cancer radiotherapy. It is necessary to constrain the heart dose when perform thoracic radiation therapy to decrease the incidence of cardiac events and improve the overall survival.

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Changes in pulmonary function and influencing factors after high-dose intrathoracic radio(chemo)therapy

et al. 2016

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DART-bid: dose-differentiated accelerated radiation therapy, 1.8 Gy twice daily

Abstract: DART-bid yields high LC without significant toxicity. For centrally located and/or large (> 5 cm) early stage tumors, where SBRT is not feasible, this method might serve as radiotherapeutic alternative to present treatment recommendations, with the need of confirmation in larger cohorts.

Cited by 9 publications

References 39 publications

Challenges in radiobiological modeling: can we decide between LQ and LQ-L models based on reviewed clinical NSCLC treatment outcome data?

Challenges in radiobiological modeling: can we decide between LQ and LQ-L models based on reviewed clinical NSCLC treatment outcome data?

Heart dose linked with cardiac events and overall survival in lung cancer radiotherapy

Changes in pulmonary function and influencing factors after high-dose intrathoracic radio(chemo)therapy

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