Late Toxicity and Long-Term Local Control in Patients With Ultra-Central Lung Tumours Treated by Intensity-Modulated Radiotherapy-Based Stereotactic Ablative Body Radiotherapy With Homogenous Dose Prescription

Accelerated Hypofractionated Magnetic Resonance Guided Adaptive Radiation Therapy for Ultracentral Lung Tumors

“…Different hypofractionated schedules have been utilized for ultracentral tumors ( Supplementary Table S1 ) [ 9 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 ], but treatment-related toxicities remain concerning ( Figure 3 ) [ 9 , 13 , 14 , 15 , 16 , 17 , 18 , 20 , 21 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 3...…”

“…Different hypofractionated schedules have been utilized for ultracentral tumors (Supplementary Table S1) [9,, but treatment-related toxicities remain concerning (Figure 3) [9,[13][14][15][16][17][18]20,21,[23][24][25][26][27][28][29][30][31][32][33][34]36,38,40,42,43]. Notably, two prior retrospective series detailed their experience with a more conservative hypofractionation schedule, administering a total of 60 Gy in 12 fractions (5 Gy per fraction), utilizing daily cone-beam computerized tomography (CBCT) for online setup and position verification.…”

“… Treatment-related toxicities associated with hypofractionated schedules from this study and other case series, showing the median total dose and median number of fractions for each study [ 9 , 13 , 14 , 15 , 16 , 17 , 18 , 20 , 21 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 36 , 38 , 40 , 42 , 43 ]. * Current study.…”

Dosimetric Analysis of Proximal Bronchial Tree Subsegments to Assess The Risk of Severe Toxicity After Stereotactic Body Radiation Therapy of Ultra-central Lung Tumors

“…This hypothesis of a relevant volume factor is further supported by the fact that other recent studies reporting higher grade ≥ 3 rates of up to 24.0 % included similarly larger tumor volumes with median PTV sizes two to three times larger compared to median PTV of the present study. [12] , [14] , [37] .…”

“… [1] , [2] , [3] , [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] After SBRT, local control (LC) rates of 80.0 % to 97.0 % after two years are comparable to surgical resection. [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] Furthermore, SBRT is increasingly used in oligometastatic cancer patients. [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] Despite major progress in the field of radiation-oncology, the safety and efficacy of SBRT in ultra-central lung tumors remains controversial.…”