Steep Dose–Response Relationship for Stage I Non–Small-Cell Lung Cancer Using Hypofractionated High-Dose Irradiation by Real-Time Tumor-Tracking Radiotherapy

Onimaru, Rikiya; Fujino, Michihiro; Yamazaki, Koichi; Onodera, Yuya; Taguchi, Hiroshi; Katoh, Norio; Hommura, Fumihiro; Oizumi, Satoshi; Nishimura, Masaharu; Shirato, Hiroki

doi:10.1016/j.ijrobp.2007.06.043

Cited by 137 publications

(90 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It is still not certain whether we should use real-time tracking of the prostate markers during the delivery of radiotherapy as RTRT for lung cancers (24), and permit irradiation only when the fiducial markers are within the gating window. Litzenberg et al suggested that 2 of their 11 patients would have benefited from continuous target tracking and threshold-based intervention from their analysis 9 of intra-fraction organ motion (11).…”

Section: Discussionmentioning

confidence: 99%

Use of Implanted Markers and Interportal Adjustment With Real-Time Tracking Radiotherapy System to Reduce Intrafraction Prostate Motion

Shimizu

Osaka

Shinohara

et al. 2011

International Journal of Radiation Oncology*Biology*Physics

Self Cite

View full text Add to dashboard Cite

Purpose: Interportal adjustment was applied to patients with prostate cancer using three fiducial markers and two sets of fluoroscopy in a real-time tumor-tracking radiotherapy (RTRT) system. The incidence of table position adjustment required to keep intrafractional uncertainty within 2.0 mm was investigated in this study. Methods and Materials:The coordinates of the center of gravity of the three fiducial markers were measured at the start of every portal irradiation in intensity-modulated radiotherapy (IMRT) with seven ports. The table position was adjusted to the planned position if the discrepancy was larger than 2.0 mm in the anterior-posterior (AP), cranio-caudal (CC), or left-right (LR) directions. In total, we analyzed 4541 observations in 20 patients who received 70 Gy in 30 fractions (7.6 times a day in average). Results:The incidence of table position adjustment at 10 minutes from the initial set-up of each treatment was 14.2%, 12.3%, and 5.0% of the observations in the AP, CC, and LR directions, respectively. The accumulated incidence of the table position adjustment was significantly higher at 10 minutes compared to that at 2 minutes for AP (p=0.0033) and CC (p=0.0110) but not LR (p=0.4296). An adjustment greater than 5 mm was required at least once in the treatment period in 11 (55%) patients. Conclusions:Interportal adjustment of table position was required in more than 10% of portal irradiations during the 10-minute period after initial set-up to maintain treatment accuracy within 2.0 mm.

show abstract

Section: Discussionmentioning

confidence: 99%

Use of Implanted Markers and Interportal Adjustment With Real-Time Tracking Radiotherapy System to Reduce Intrafraction Prostate Motion

Shimizu

Osaka

Shinohara

et al. 2011

International Journal of Radiation Oncology*Biology*Physics

Self Cite

View full text Add to dashboard Cite

show abstract

“…Onimaru et al reported that the difference in the local control rate between 40 and 48 Gy in 4 fractions at the isocenter was larger with stage IB than with stage IA [10].…”

Section: Introductionmentioning

confidence: 99%

Phase I study of stereotactic body radiation therapy for peripheral T2N0M0 non-small cell lung cancer with PTV < 100 cc using a continual reassessment method (JCOG0702)

Onimaru

Shirato

Shibata

et al. 2015

Radiotherapy and Oncology

Self Cite

View full text Add to dashboard Cite

Key Words: phase I study, continual reassessment method, non-small cell lung cancer (NSCLC), stereotactic body radiotherapy, SBRT. Short running title: Previous presentationThis work was presented at the 55th Annual Meeting of the American Society for Radiation Oncology, September 22 -25, 2013 in Atlanta, GA. / 28Abstract Purpose: To estimate the maximum tolerated dose (MTD) and to determine the recommended dose (RD) of stereotactic body radiation therapy (SBRT) for peripheral T2N0M0 non-small cell carcinoma (NSCLC) with target volume (PTV) < 100 cc. Materials and Methods:The continual reassessment method (CRM) was used to determine the dose level that patients should be assigned to and to estimate the MTD. Dose limiting toxicity (DLT) was grade 3 radiation pneumonitis (RP) within 180 days after the start of SBRT, grade 2 RP was used as a surrogate DLT. The RD was equal to the MTD. The dose was prescribed at D 95 of the PTV.Results: Fifteen patients were accrued. Only 1 experienced grade 2 RP at 60 Gy in 4fractions. It was difficult to fulfill the dose constraints at 60 Gy in 4 fractions, and the maximum dose level assigned by CRM was changed to 55 Gy in 4 fractions. The lower limit of 95% of the credible interval exceeded the adjacent level, and the RD was determined as 55 Gy in 4 fractions. Conclusions:The RD of SBRT for peripheral T2N0M0 NSCLC with PTV < 100 cc was determined to be 55 Gy in 4 fractions. / 28

show abstract

“…There can be a dose-response relationship between tumor size and the irradiated dose in SBRT [5][6][7][8], and Kestin et al reported that higher doses are associated with better survival for T1-T2N0M0 NSCLC [5]. Guckenberger et al reported that a strong dose-response relationship was observed in NSCLC [6].…”

Section: Introductionmentioning

confidence: 99%

Phase I study of stereotactic body radiation therapy for peripheral T2N0M0 non-small cell lung cancer (JCOG0702): Results for the group with PTV ⩾ 100 cc

Onimaru

Oda

Shibata

et al. 2017

Radiotherapy and Oncology

Self Cite

View full text Add to dashboard Cite

Purpose: A dose escalation study to determine the recommended dose (RD) with stereotactic body radiation therapy (SBRT) for peripheral T2N0M0 non-small cell carcinomas (NSCLC) was conducted. The results of the group with PTV ≥ 100 cc is reported in this paper. Materials and Methods:The continual reassessment method (CRM) was used to determine the dose level that patients should be assigned to and to estimate the maximum tolerated dose (MTD). Dose limiting toxicity (DLT) was Grade 3 or higher radiation pneumonitis (RP), and Grade 2 or higher RP was used as a surrogate DLT. The RD was equal to the MTD. The dose was prescribed at D 95 of the PTV.Results: Thirteen patients were accrued. More patients should have been enrolled but we decided not to prolong the study period. No patients experienced Grade 3 RP. Two patients experienced Grade 2 RP at 50 Gy in 4 fractions. The predicted MTD was 50.2Gy. The posterior probability of the Grade 2 RP frequency over 40% was 5.3% for the dose level of 50 Gy. The RD was determined to be 50 Gy.

show abstract

Steep Dose–Response Relationship for Stage I Non–Small-Cell Lung Cancer Using Hypofractionated High-Dose Irradiation by Real-Time Tumor-Tracking Radiotherapy

Abstract: A steep dose-response curve between 40 and 48 Gy using a daily dose of 12 Gy delivered in one week was identified for stage IB NSCLC in SBRT using RTRT.

Cited by 137 publications

References 34 publications

Use of Implanted Markers and Interportal Adjustment With Real-Time Tracking Radiotherapy System to Reduce Intrafraction Prostate Motion

Use of Implanted Markers and Interportal Adjustment With Real-Time Tracking Radiotherapy System to Reduce Intrafraction Prostate Motion

Phase I study of stereotactic body radiation therapy for peripheral T2N0M0 non-small cell lung cancer with PTV < 100 cc using a continual reassessment method (JCOG0702)

Phase I study of stereotactic body radiation therapy for peripheral T2N0M0 non-small cell lung cancer (JCOG0702): Results for the group with PTV ⩾ 100 cc

Contact Info

Product

Resources

About