Early-Stage Primary Lung Neuroendocrine Tumors Treated With Stereotactic Body Radiation Therapy: A Multi-Institution Experience

Oliver, Daniel; Laborde, Jose; Singh, Deepinder; Milano, Michael T.; Videtic, Gregory M.M.; Williams, G.R.; LaRiviere, Michael J.; Chan, Jason W.; Peters, Gabrielle W.; Decker, Roy H.; Samson, Pamela; Robinson, C.G.; Breen, William; Owen, Dawn; Tian, Sibo; Higgins, Kristin; Almeldin, D.S.; Jabbour, Salma K.; Wang, Fen; Grass, G. Daniel; Perez, Bradford A.; Strosberg, Jonathan R.; Rosenberg, Stephen A.

doi:10.1016/j.ijrobp.2023.01.028

Cited by 4 publications

(5 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Local management of unresectable liver metastases such as transarterial (radio)embolization (TA(R)E) and radiofrequency ablation (RFA), can be considered. SBRT is an additional option for treating progressive metastases not only from the liver, but across all body sites, with low rates of acute and late toxicities (Chen et al, 2021;Hudson et al, 2022;Oliver et al, 2023). Finally, in the setting of diffuse disease progression following SSA treatment for Grade 1 and 2 disease, PRRT is indicated (Strosberg et al, 2017) Despite the excellent results with the use of PRRT as demonstrated in NETTER-1, the heterogeneous nature of neuroendocrine tumors provides further opportunity to optimize the use of this modality and potentially expand the scope of patients who may benefit.…”

Section: Discussionmentioning

confidence: 99%

“…Further, it is being widely investigated as an option to boost gross oligometastatic disease in the context of standard of care systemic treatment (Palma et al, 2019;Wang et al, 2023). Specific to neuroendocrine tumors, SBRT is emerging as an effective treatment of both primary and metastatic disease (Chen et al, 2021;Hudson et al, 2022;Oliver et al, 2023) Further, SBRT may assist in providing hormonal control in functional NEN (Myrehaug et al, 2020) The combination of PRRT and SBRT in the treatment of neuroendocrine tumors may have a synergistic impact, improving overall efficacy. PRRT provides systemic radiation treatment targeting tumor cells utilizing SSTR2 receptors, whereas SBRT delivers ultra-high doses of radiation to a specific area irrespective of the underlying tumor biology.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Tolerability and outcomes of neuroendocrine tumors treated with PRRT and SBRT

Nunez,

Ng,

Chen

et al. 2024

Endocrine Oncology

View full text Add to dashboard Cite

There is interest in optimizing peptide receptor radionuclide therapy (PRRT) for the management of metastatic neuroendocrine neoplasms (NEN). The addition of stereotactic body radiation therapy (SBRT) may provide synergistic benefit by targeting specific sites of disease that may represent areas of tumor heterogeneity. Little is known around the efficacy or potential toxicity of this approach. An institutional retrospective review of patients with NEN treated with sequential PRRT and SBRT was performed to provide preliminary outcome and toxicity data to inform further treatment and clinical trial strategies combining these therapies.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Tolerability and outcomes of neuroendocrine tumors treated with PRRT and SBRT

Nunez,

Ng,

Chen

et al. 2024

Endocrine Oncology

View full text Add to dashboard Cite

show abstract

“…Owing to the good local control achieved using this technique, SBRT is widely performed for inoperable early‐stage primary and metastatic lung cancer. 1 , 2 , 3 , 4 , 5 , 6 …”

Section: Introductionmentioning

confidence: 99%

“…Stereotactic body radiation therapy (SBRT) delivers a precise high dose of radiation to a limited target volume. Owing to the good local control achieved using this technique, SBRT is widely performed for inoperable early‐stage primary and metastatic lung cancer 1–6 …”

Section: Introductionmentioning

confidence: 99%

“…Owing to the good local control achieved using this technique, SBRT is widely performed for inoperable early-stage primary and metastatic lung cancer. [1][2][3][4][5][6] Lung tumors can move by more than 30 mm. 7 In lung SBRT, the tumor motion during breathing results in significant geometric uncertainty during high-dose delivery to the target.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Intra‐ and inter‐fractional variations of tumors with fiducial markers measured using respiratory‐correlated computed tomography images for respiratory gated lung stereotactic body radiation therapy

Manabe,

Shiinoki,

Fujimoto

et al. 2024

J Applied Clin Med Phys

View full text Add to dashboard Cite

PurposeThis study evaluated the intra‐ and inter‐fractional variation of tumors with fiducial markers (FMs), relative to the tumor‐FM distance, to establish how close an FM should be inserted for respiratory‐gated stereotactic body radiation therapy (RG‐SBRT).MethodsForty‐five lung tumors treated with RG‐SBRT were enrolled. End‐expiratory computed tomography (CT) (CTplan) and four‐dimensional‐CT (4D‐CT) scans were obtained for planning. End‐expiratory CT (CTfr) scanning was performed before each fraction. The FMs were divided into two groups based on the median tumor‐FM distance in the CTplan (Dp). For the intra‐fractional variation, the correlations between the corresponding tumor and FM intra‐fractional motions, defined as the centroid coordinates of those in each 0–90% phase, with the 50% phase of 4D‐CT as the origin, were calculated in the left‐right, anterior‐posterior, and superior‐inferior directions. Furthermore, the maximum difference in the tumor‐FM distance in each phase of 4D‐CT scan, based on those in the 50% phase of 4D‐CT scan (Dmax), was obtained. Inter‐fractional variation was defined as the maximum distance between the tumors in CTplan and CTfr, when the CT scans were fused based on each FM or vertebra.ResultsThe median Dp was 26.1 mm. While FM intra‐fractional motions were significantly and strongly correlated with the tumor intra‐fractional motions in only anterior‐posterior and superior‐inferior directions for the Dp > 26 mm group, they were significantly and strongly correlated in all directions for the Dp ≤ 26 mm group. In all directions, Dmax values of the Dp ≤ 26 mm group were lower than those of the Dp > 26 mm group. The inter‐fractional variations based on the Dp ≤ 26 mm were smaller than those on the Dp > 26 mm and on the vertebra in all directions.ConclusionsRegarding intra‐ and inter‐fractional variation, FMs for Dp ≤ 26 mm can increase the accuracy for RG‐SBRT.

show abstract