Stereotactic Body Radiotherapy (SBRT) for Operable Stage I Non–Small-Cell Lung Cancer: Can SBRT Be Comparable to Surgery?

Oda, Hiroshi; Shirato, Hiroki; Nagata, Yasushi; Hiraoka, Masahiro; Fujino, Michihiro; Gomi, Kotaro; Kiura, Katsuyuki; Hayakawa, Kazushige; Niibe, Yuzuru; Takai, Yoshihiro; Kimura, Tomoki; Takeda, Atsuya; Ouchi, Atsushi; Hareyama, Masato; Kitajima, Masaki; Kozuka, Takuyo; Arimoto, Takuro; Hara, Ryusuke; Itami, Jun; Araki, Tsutomu

doi:10.1016/j.ijrobp.2009.07.1751

Cited by 536 publications

(394 citation statements)

References 31 publications

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“…Initial clinical results from prospective single institution, and more recently, multi‐institutional clinical trials of SABR have documented high rates of tumor control coupled with a low incidence of serious toxicity despite the high‐dose fractions of radiation being delivered. In the setting of early stage lung cancer, three‐year local control rates of 88% to 97% have been reported 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 …”

Section: Introductionmentioning

confidence: 99%

Commissioning and initial stereotactic ablative radiotherapy experience with Vero

Solberg

Medin

Ramirez

et al. 2014

J Applied Clin Med Phys

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The purpose of this study is to describe the comprehensive commissioning process and initial clinical performance of the Vero linear accelerator, a new radiotherapy device recently installed at UT Southwestern Medical Center specifically developed for delivery of image‐guided stereotactic ablative radiotherapy (SABR). The Vero system utilizes a ring gantry to integrate a beam delivery platform with image guidance systems. The ring is capable of rotating ± 60° about the vertical axis to facilitate noncoplanar beam arrangements ideal for SABR delivery. The beam delivery platform consists of a 6 MV C‐band linac with a 60 leaf MLC projecting a maximum field size of 15×15 cm2 at isocenter. The Vero planning and delivery systems support a range of treatment techniques, including fixed beam conformal, dynamic conformal arcs, fixed gantry IMRT in either SMLC (step‐and‐shoot) or DMLC (dynamic) delivery, and hybrid arcs, which combines dynamic conformal arcs and fixed beam IMRT delivery. The accelerator and treatment head are mounted on a gimbal mechanism that allows the linac and MLC to pivot in two dimensions for tumor tracking. Two orthogonal kV imaging subsystems built into the ring facilitate both stereoscopic and volumetric (CBCT) image guidance. The system is also equipped with an always‐active electronic portal imaging device (EPID). We present our commissioning process and initial clinical experience focusing on SABR applications with the Vero, including: (1) beam data acquisition; (2) dosimetric commissioning of the treatment planning system, including evaluation of a Monte Carlo algorithm in a specially‐designed anthropomorphic thorax phantom; (3) validation using the Radiological Physics Center thorax, head and neck (IMRT), and spine credentialing phantoms; (4) end‐to‐end evaluation of IGRT localization accuracy; (5) ongoing system performance, including isocenter stability; and (6) clinical SABR applications.PACS number: 87.53.Ly

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Section: Introductionmentioning

confidence: 99%

Commissioning and initial stereotactic ablative radiotherapy experience with Vero

Solberg

Medin

Ramirez

et al. 2014

J Applied Clin Med Phys

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“…Prescribing dose at the 70% isodose allows, in the majority of cases, fulfilment of the dose constraints to OARs. We chose this schedule be- [ 13] [12], a BED >100 Gy is one of the most important parameters by which to obtain an increase in local control. The use of modern radiation techniques such as SBRT allows high-precision treatment of lesions located in a "dangerous" position.…”

Section: Discussionmentioning

confidence: 99%

Stereotactic body radiotherapy for cardiac and paracardiac metastases: University of Florence experience

et al. 2013

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Purpose. This study sought to evaluate acute toxicity and local control in patients who underwent extracranial stereotactic body radiation therapy (SBRT) for paracardiac and cardiac metastatic lesions, defined as such when located at a maximum distance of 1 cm from the heart or inside its parenchyma. Materials and methods. Between January 2009 and May 2011, 16 patients with paracardiac and cardiac lesions were treated with SBRT. For dose specification, in 15 of 16 patients, the prescription dosage was 36 Gy in three fractions (70% isodose). In one patient, the target lesion was inside the heart, and the prescription dosage was 30 Gy in three fractions (70% isodose). Results. Regarding response to stereotactic radiotherapy, we recorded one (6%) complete response (CR), six (37%) partial responses (PR), five (32%) stable disease (SD) and four (25%) local failures. Median interval to local failure was 5.2 (range, 3-12) months. The cause of death was distant progression of disease in all four patients. Compliance to treatment was excellent; no patient developed cardiological symptoms or electrocardiographic abnormalities, even months after SBRT. Conclusions. Results of our retrospective study indicate that SBRT represents a safe and effective treatment option for patients with cardiac and paracardiac metastases. Keywords

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“…It will also be of interest to determine whether PBT or SBRT can be applied for these diseases when surgical resection is judged to be impossible. Besides, some studies have shown favorable results for operable early stage NSCLC treated with photon SBRT [57,58], and these results indicate that SBRT or PBT could be used for operable NSCLC. However, lobectomy or pneumonectomy is the standard treatment for invasive NSCLC, therefore, an additional assessment of indication of SBRT or PBT for operable NSCLC may …”

Section: Expert Commentarymentioning

confidence: 91%

The use of proton-beam therapy in the treatment of non-small-cell lung cancer

Oshiro¹,

Sakurai

2013

Expert Review of Medical Devices

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Stereotactic Body Radiotherapy (SBRT) for Operable Stage I Non–Small-Cell Lung Cancer: Can SBRT Be Comparable to Surgery?

Cited by 536 publications

References 31 publications

Commissioning and initial stereotactic ablative radiotherapy experience with Vero

Commissioning and initial stereotactic ablative radiotherapy experience with Vero

Stereotactic body radiotherapy for cardiac and paracardiac metastases: University of Florence experience

The use of proton-beam therapy in the treatment of non-small-cell lung cancer

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