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首页> 外文期刊>Acta oncologica. >Optimizing SABR delivery for synchronous multiple lung tumors using volumetric-modulated arc therapy
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Optimizing SABR delivery for synchronous multiple lung tumors using volumetric-modulated arc therapy

机译：使用体积调制电弧疗法优化同步多肺肿瘤的SABR递送

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摘要

Background: Volumetric-modulated arc therapy (VMAT) delivery for stereotactic ablative radiotherapy (SABR) of multiple lung tumors allows for faster treatments. We report on clinical outcomes and describe a general approach for treatment planning.Material and methods: Patients undergoing multi iso-center VMAT-based SABR for 2 lung lesions between 2009 and 2014 were identified from the VU University Medical Center and London Health Sciences Centre. Patients were eligible if the start date of the SABR treatment for the different lesions was within a time range of 30 days. SABR was delivered using separate iso-centers for lesions at a substantial distance from each other. Tumors were either treated with a single fraction of 34Gy, or using three risk-adapted dose-fractionation schemes, namely three fractions of 18Gy, five fractions of 11Gy, or eight fractions of 7.5Gy, depending on the tumor size and the location. Multivariable analysis was performed to assess factors predictive of clinical outcomes.Results: Of 84 patients (188 lesions) identified, 46% were treated for multiple metastases and 54% for multiple primary NSCLC. About 97% were treated for two or three lesions, and 56% had bilateral disease. After a median follow-up of 28 months, median overall survival (OS) for primary tumors was 27.6 months, and not reached for metastatic lesions (p=.028). Grade 3 toxicity was observed in 2% of patients. Multivariable analysis showed that grade 2 or higher radiation pneumonitis (n=9) was best predicted by a total lung V35(Gy) of 6.5% (in 2Gy/fraction equivalent) (p=.007).Conclusion: Severe toxicity was uncommon following SABR using VMAT for up to three lung tumors. Further investigations of planning parameters are needed in patients presenting with more lesions.
机译：背景技术：多种肺肿瘤的立体定向烧蚀放射疗法（SABR）的体积调制的电弧疗法（VMAT）递送允许更快的治疗方法。我们报告了临床结果，并描述了治疗计划的一般方法。从VU大学医学中心和伦敦健康科学中心确定了2009年至2014年肺病灶的多样性VMAT的SABR患者。如果不同病变的SABR处理的开始日期，患者均有资格在30天的时间范围内。 SABR使用单独的ISO中心递送，彼此大幅距离。肿瘤或者用单一的34Gy级分，或使用三种风险适应剂量分级方案，即18Gy，五分之分的11Gy的三分之一，或7.5只为7.5级，这取决于肿瘤大小和位置。进行多变量分析以评估预测临床结果的因素。结果：鉴定了84名患者（188例），治疗了46％的多种转移，多次初级NSCLC治疗54％。约97％的治疗治疗两三个病变，56％有双侧疾病。在28个月的中位随访后，原发性肿瘤的中位数存活率（OS）为27.6个月，未达到转移性病变（P = .028）。在2％的患者中观察到3级毒性。多变量分析表明，2级或更高的辐射肺炎（N = 9）最佳地预测了6.5％的总肺V35（GY）（在2gs /级分当量）（p = .007）。结论：严重的毒性罕见以下SABR使用VMAT达到三种肺肿瘤。患有更多病变的患者需要进一步调查规划参数。

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  • 来源
    《Acta oncologica.》 |2017年第6期|共7页
  • 作者

    Tekatli Hilal; Tetar Shyama U.; Nguyen Timothy K.; Warner Andrew; Verbakel Wilko F.; Palma David A.; Dahele Max; Gaede Stewart; Haasbeek Cornelis; Spoelstra Femke O.; de Haan Patricia F.; Slotman Ben J.; Senan Suresh;

  • 作者单位

    Vrije Univ Amsterdam Dept Radiat Oncol Med Ctr Postbox 7057 NL-1007 MB Amsterdam Netherlands;

    Vrije Univ Amsterdam Dept Radiat Oncol Med Ctr Postbox 7057 NL-1007 MB Amsterdam Netherlands;

    London Hlth Sci Ctr Dept Radiat Oncol London ON Canada;

    London Hlth Sci Ctr Dept Radiat Oncol London ON Canada;

    Vrije Univ Amsterdam Dept Radiat Oncol Med Ctr Postbox 7057 NL-1007 MB Amsterdam Netherlands;

    London Hlth Sci Ctr Dept Radiat Oncol London ON Canada;

    Vrije Univ Amsterdam Dept Radiat Oncol Med Ctr Postbox 7057 NL-1007 MB Amsterdam Netherlands;

    London Hlth Sci Ctr Dept Radiat Oncol London ON Canada;

    Vrije Univ Amsterdam Dept Radiat Oncol Med Ctr Postbox 7057 NL-1007 MB Amsterdam Netherlands;

    Vrije Univ Amsterdam Dept Radiat Oncol Med Ctr Postbox 7057 NL-1007 MB Amsterdam Netherlands;

    Vrije Univ Amsterdam Dept Radiat Oncol Med Ctr Postbox 7057 NL-1007 MB Amsterdam Netherlands;

    Vrije Univ Amsterdam Dept Radiat Oncol Med Ctr Postbox 7057 NL-1007 MB Amsterdam Netherlands;

    Vrije Univ Amsterdam Dept Radiat Oncol Med Ctr Postbox 7057 NL-1007 MB Amsterdam Netherlands;

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  • 正文语种 eng
  • 中图分类 肿瘤学;
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