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Influence of Fractionation Scheme and Tumor Location on Toxicities After Stereotactic Body Radiation Therapy for Large (≥5 cm) Non-Small Cell Lung Cancer: A Multi-institutional Analysis.
- Source :
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International Journal of Radiation Oncology, Biology, Physics . Mar2017, Vol. 97 Issue 4, p778-785. 8p. - Publication Year :
- 2017
-
Abstract
- <bold>Purpose: </bold>To describe the impact of fractionation scheme and tumor location on toxicities in stereotactic body radiation therapy (SBRT) for ≥5-cm non-small cell lung cancer (NSCLC), as part of a multi-institutional analysis.<bold>Methods: </bold>Patients with primary ≥5-cm N0 M0 NSCLC who underwent ≤5-fraction SBRT were examined across multiple high-volume SBRT centers. Collected data included clinical/treatment parameters; toxicities were prospectively assessed at each institution according to the Common Terminology Criteria for Adverse Events. Patients treated daily were compared with those treated every other day (QOD)/other nondaily regimens. Stratification between central and peripheral tumors was also performed.<bold>Results: </bold>Ninety-two patients from 12 institutions were evaluated (2004-2016), with median follow-up of 12 months. In total there were 23 (25%) and 6 (7%) grade ≥2 and grade ≥3 toxicities, respectively. Grades 2 and 3 pulmonary toxicities occurred in 9% and 4%, respectively; 1 patient treated daily experienced grade 5 radiation pneumonitis. Of the entire cohort, 46 patients underwent daily SBRT, and 46 received QOD (n=40)/other nondaily (n=6) regimens. Clinical/treatment parameters were similar between groups; the QOD/other group was more likely to receive 3-/4-fraction schemas. Patients treated QOD/other experienced significantly fewer grade ≥2 toxicities as compared with daily treatment (7% vs 43%, P<.001). Patients treated daily also had higher rates of grade ≥2 pulmonary toxicities (P=.014). Patients with peripheral tumors (n=66) were more likely to receive 3-/4-fraction regimens than those with central tumors (n=26). No significant differences in grade ≥2 toxicities were identified according to tumor location (P>.05).<bold>Conclusions: </bold>From this multi-institutional study, toxicity of SBRT for ≥5-cm lesions is acceptable, and daily treatment was associated with a higher rate of toxicities. [ABSTRACT FROM AUTHOR]
- Subjects :
- *NON-small-cell lung carcinoma
*DOSE fractionation
*STEREOTACTIC radiotherapy
*RADIATION pneumonitis
*SCHEMAS (Psychology)
*COMPARATIVE studies
*LONGITUDINAL method
*DOSE-response relationship (Radiation)
*LUNG cancer
*LUNG tumors
*RESEARCH methodology
*MEDICAL cooperation
*RADIATION doses
*RADIOSURGERY
*RESEARCH
*SURVIVAL
*COMORBIDITY
*EVALUATION research
*TREATMENT effectiveness
*DISEASE prevalence
*RETROSPECTIVE studies
*PREVENTION
Subjects
Details
- Language :
- English
- ISSN :
- 03603016
- Volume :
- 97
- Issue :
- 4
- Database :
- Academic Search Index
- Journal :
- International Journal of Radiation Oncology, Biology, Physics
- Publication Type :
- Academic Journal
- Accession number :
- 121355562
- Full Text :
- https://doi.org/10.1016/j.ijrobp.2016.11.049