? 2016 Aoki et al.Background: To evaluate clinical outcomes of stereotactic body radiotherapy (SBRT) for localized primary and oligometastatic lung tumors by assessing efficacy and safety of 5 regimens of varying fraction size and number. Methods: One-hundred patients with primary lung cancer (n = 69) or oligometastatic lung tumors (n = 31), who underwent SBRT between May 2003 and August 2010, were included. The median age was 75 years (range, 45-88). Of them, 98 were judged to have medically inoperable disease, predominantly due to chronic illness or advanced age. SBRT was performed using 3 coplanar and 3 non-coplanar fixed beams with a standard linear accelerator. Fraction sizes were escalated by 1 Gy, and number of fractions given was decreased by 1 for every 20 included patients. Total target doses were between 50 and 56 Gy, administered as 5-9 fractions. The prescribed dose was defined at the isocenter, and median overall treatment duration was 10 days (range, 5-22). Results: The median follow-up was 51.1 months for survivors. The 3-year local recurrence rates for primary lung cancer and oligometastasis was 6 % and 3 %, respectively. The 3-year local recurrence rates for tumor sizes ?3 cm and >3 cm were 3 % and 14 %, respectively (p = 0.124). Additionally, other factors (fraction size, total target dose, and BED10) were not significant predictors of local control. Radiation pneumonia (? grade 2) was observed in 2 patients. Radiation-induced rib fractures were observed in 22 patients. Other late adverse events of greater than grade 2 were not observed. Conclusion: Within this dataset, we did not observe a dose response in BED10 values between 86.4 and 102.6 Gy. SBRT with doses between 50 and 56 Gy, administered over 5-9 fractions achieved acceptable tumor control without severe complications.
Aoki, M., Hatayama, Y., Kawaguchi, H., Hirose, K., Sato, M., Akimoto, H., … Takai, Y. (2016). Clinical outcome of stereotactic body radiotherapy for primary and oligometastatic lung tumors: A single institutional study with almost uniform dose with different five treatment schedules. Radiation Oncology, 11(1). https://doi.org/10.1186/s13014-016-0581-2