Stereotactic ablative radiotherapy (SABR) using 70Gy in 10 fractions for non-small cell lung cancer: Exploration of clinical indications

Li, Qiaoqiao; Swanick, Cameron W.; Allen, Pamela K.; Gomez, Daniel R.; Welsh, James W.; Liao, Zhongxing; Balter, Peter A; Chang, Joe Y.

doi:10.1016/j.radonc.2014.07.010

Cited by 81 publications

(68 citation statements)

References 23 publications

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“…V 30 has also been found to be important in other studies examining SABR-associated chest wall pain, although there is variation in how these analyses were performed. 9,10,[21][22][23] As above, we observed that the maximum chest wall dose (evaluated as D max 1 cm 3 ) was a significant predictor in the risk of chest wall pain. Similarly, Andolino et al 11 and Taremi et al 24 found maximum doses (point dose and D max 0.5 cm 3 , respectively) to be important in the development of chest wall pain.…”

Section: Discussionsupporting

confidence: 71%

Lung stereotactic ablative radiotherapy (SABR): dosimetric considerations for chest wall toxicity

Murray

Karakaya

Hinsley

et al. 2016

BJR

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Section: Discussionsupporting

confidence: 71%

Lung stereotactic ablative radiotherapy (SABR): dosimetric considerations for chest wall toxicity

Murray

Karakaya

Hinsley

et al. 2016

BJR

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“…9,36,[50][51][52][53]56,57,[59][60][61][62][63][64][65][66][67][68][69][70][71][72][73][74][75] In terms of tumour dose, the LungTech protocol will investigate a medium hypofractionated approach, applying 8.0 3 7.5 Gy to a total dose of 60 Gy; this is equal to a BED of 105 Gy (a/b 5 10). Referring to report 83 of the International Commission on Radiation Units and Measurements (ICRU), 95% of the PTV has to receive at least the nominal fraction dose, and 99% of the PTV receives a minimum of 90% of the nominal dose.…”

Section: Prescribed Dose Normal Tissue Constraintsmentioning

confidence: 99%

LungTech, an EORTC Phase II trial of stereotactic body radiotherapy for centrally located lung tumours: a clinical perspective

Adebahr¹,

Collette²,

Shash³

et al. 2015

BJR

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Evidence supports stereotactic body radiotherapy (SBRT) as a curative treatment option for inoperable early stage nonsmall-cell lung cancer (NSCLC) resulting in high rates of tumour control and low risk of toxicity. However, promising results are mainly derived from SBRT of peripheral pulmonary lesions, whereas SBRT for the central tumours can lead to severe radiation sequelae owing to the spatial proximity to the serial organs at risk. Robust data on the tolerance of mediastinal structures to high-dose hypofractionated radiation are limited; furthermore, there are many open questions regarding the efficiency, safety and response assessment of SBRT in inoperable, centrally located early stage NSCLC, which are addressed in a prospective multicentre study [sponsored by the European Organization for Research and Treatment of Cancer (EORTC 22113-08113-LungTech)]. In this review, we summarize the current status regarding SBRT for centrally located early stage NSCLC that leads to the rationale of the LungTech trial. Outline and some essential features of the study with focus on a summary of current experiences in dose/fraction-toxicity coherences after SBRT to the mediastinal structures that lead to LungTech normal tissue constraints are provided.Stereotactic body radiotherapy (SBRT) is a technique in which high doses of radiotherapy are very precisely delivered with steep dose gradients and a short overall treatment time (OTT). This achieves a very high biological dose.1 Evidence supports SBRT as a curative treatment option for inoperable early stage non-small-cell-lung cancer (NSCLC).2-5 Highprecision, hypofractionated dose delivery enables a significant reduction in both target volume size and exposure of normal tissue (NT) to high doses, resulting in a decreased toxicity risk and high rates of local control.6-8 However, promising results are mainly derived from the SBRT of small peripheral pulmonary lesions with low risk of treatment-related toxicity, as these tumours are surrounded by parallel organs at risk (OARs), specifically lung tissue. In contrast, the SBRT for central tumours can lead to severe, potentially life-threatening radiation sequelae owing to the spatial proximity to serial OARs. As robust, prospective and multicentre data on the tolerance of mediastinal structures to high-dose hypofractionated radiation is limited, there is generally caution in implementing SBRT for central lung tumours. Current published data are rather inconsistent regarding the definition of "central tumour", SBRT techniques, dose prescription and reporting, calculation algorithms, image guidance and evaluation of outcome. A recent systematic review has summarized the current limited evidence on this topic, mainly from singlecentre experiences, 9 but there are still many open questions

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“…Utvrđeno je da oligometastatska bolest ima bolju prognozu i duže ukupno preživljenje u odnosu na diseminiranu tzv. polimetastatsku bolest i stoga je lokalna kontrola malobrojnih metastatskih depozita preporučena [28][29][30][31][32][33].…”

Section: Diskusijaunclassified

Zaštita Od Zračenja Pacijenata U Toku Radioterapijskog Tretmana Primjenom Modernih Tehnika Zračenja

Trokić¹,

Marosevic²,

Jaroš³

et al. 2018

Zaštita Od Jonizirajućeg Zračenja Kod Medicinske Ekspozicije

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ApstraktCilj: prikazati metodologiju rada primjenom modernih tehnika zračenja. Pozadina: Tehnološki razvoj rezultirao je implementacijom novih tehnika zračenja i omogućio preciznu isporuku visokih doza zračenja na ciljni volumen uz maksimalnu poštedu okolnih zdravih tkiva. Metodologija: priprema pacijenta na 4DCT-simulatoru uz adekvatnu imobilizaciju, fuzija simulacione CT slike s dijagnostičkim CT/MRI/PET, delineacija volumena zračenja i zdravih organa. Planiranje zračenja provodi se prema VMAT/RapidArc: Eclipse TPS protokolu s ciljem eskalacije doze u targetu i maksimalnom poštedom zdravih tkiva strmim padom doze. To se postiže izocentričnom isporukom doze iz više sekvencijalnih malih snopova zračenja nejednakog intenziteta (IMRT) ili Arc-tehnikom iz izvora koji kruži oko pacijenta za 360 o , dok je volumen zračenja moduliran dinamičkim pomjeranjem listova kolimatora (VMAT SRS/SRT, SBRT). Preciznost isporuke doze provjerom pozicije targeta osigurava se slikovnim vođenjem radioterapije (IGRT) tokom isporuke doze (OBI CBCT). Diskusija: primjena modernih tehnika zračenja zahtijeva visokosofisticiranu opremu i educirano osoblje, što omogućava isporuku visokih doza zračenja na tumorsko tkivo. Pošteda zdravih tkiva je značajna u odnosu na ranije tehnike, ali istovremeno se malim dozama ozrači veći volumen zdravog tkiva. Zaključak: Isporuka visokih doza zračenja na tumorsko tkivo je u direktnoj korelaciji s boljom tumorskom kontrolom, uz doze na zdrava tkiva ispod granice doze koja ne dovodi do značajnijeg poremećaja funkcije (<5% komplikacija). Provođenje QA procedura u cilju kontrole visokih terapijskih doza na target i niskih doza na zdrava tkiva u cilju prevencije ranih i kasnih nusefekata.Ključne riječi: zaštita, zračenje, SRT/SBRT, IMRT.* Studija prikazana u članku provedena je u Affidea IMC Centru za radioterapiju Banja Luka

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Stereotactic ablative radiotherapy (SABR) using 70Gy in 10 fractions for non-small cell lung cancer: Exploration of clinical indications

Cited by 81 publications

References 23 publications

Lung stereotactic ablative radiotherapy (SABR): dosimetric considerations for chest wall toxicity

Lung stereotactic ablative radiotherapy (SABR): dosimetric considerations for chest wall toxicity

LungTech, an EORTC Phase II trial of stereotactic body radiotherapy for centrally located lung tumours: a clinical perspective

Zaštita Od Zračenja Pacijenata U Toku Radioterapijskog Tretmana Primjenom Modernih Tehnika Zračenja

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