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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.

Authors :
Verma, Vivek
Shostrom, Valerie K.
Zhen, Weining
Zhang, Mutian
Braunstein, Steve E.
Holland, John
Hallemeier, Christopher L.
Harkenrider, Matthew M.
Iskhanian, Adrian
Jabbour, Salma K.
Attia, Albert
Lee, Percy
Wang, Kyle
Decker, Roy H.
McGarry, Ronald C.
IISimone, Charles B.
Simone, Charles B 2nd
Source :
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]

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