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Thibault Vieira, Jean-Baptiste Stern, Philippe Girard, Raffaelle Caliandro
The expanded possibilities to explore the lung deeper with new tools such as electromagnetic navigation bronchoscopy (ENB) or radial probe endobronchial ultrasonography (radial EBUS), combined with miniaturization of traditional local therapies such as radiofrequency ablation (RFA), radiotherapy, cryotherapy or photodynamic therapy, let the bronchoscopists hope for new ways of endoscopic treatments. This challenge could change the practice in the upcoming decades but raise some physical and technical issues...
April 2018: Journal of Thoracic Disease
Han Liu, Benjamin Sintay, Keith Pearman, Qingyang Shang, Lane Hayes, Jacqueline Maurer, Caroline Vanderstraeten, David Wiant
The photon optimization (PO) algorithm was recently released by Varian Medical Systems to improve volumetric modulated arc therapy (VMAT) optimization within Eclipse (Version 13.5). The purpose of this study is to compare the PO algorithm with its predecessor, progressive resolution optimizer (PRO) for lung SBRT and brain SRS treatments. A total of 30 patients were selected retrospectively. Previously, all the plans were generated with the PRO algorithm within Eclipse Version 13.6. In the new version of PO algorithm (Version 15), dynamic conformal arcs (DCA) were first conformed to the target, then VMAT inverse planning was performed to achieve the desired dose distributions...
May 20, 2018: Journal of Applied Clinical Medical Physics
Yukinori Matsuo, Takamasa Mitsuyoshi, Takashi Shintani, Yusuke Iizuka, Takashi Mizowaki
PURPOSE: The purpose of the present study was to retrospectively evaluate impact of pre-treatment skeletal muscle mass (SMM) on overall survival and non-lung cancer mortality after stereotactic body radiotherapy (SBRT) for patients with stage I non-small cell lung cancer (NSCLC). METHODS AND MATERIALS: One-hundred and eighty-six patients whose abdominal CT before the treatment was available were enrolled into this study. The patients were divided into two groups of SMM according to gender-specific thresholds for unilateral psoas area...
May 17, 2018: Journal of Geriatric Oncology
Yuming Wan, Jing Huang, Feng Xu
A few study has proven that about 90% of local control rates might be benefit from stereotactic body radiotherapy (SBRT) for patients with medically inoperable stage I non-small cell lung cancer (NSCLC), it is reported SBRT associated overall survival and tumor specific survival is comparable with those treated with surgery. SBRT has been accepted as the first line treatment for inoperable patients with peripheral located stage I NSCLC. However, the role of SBRT in centrally located lesions is controversial for potential toxic effects from the adjacent anatomical structure...
May 20, 2018: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
Meredith Giuliani, Ashwathy S Mathew, Houda Bahig, Scott V Bratman, Edith Filion, Daniel Glick, Alexander V Louie, Srinivas Raman, Anand Swaminath, Andrew Warner, Vivian Yau, David Palma
BACKGROUND: Lung stereotactic body radiotherapy (SBRT) is considered a standard curative treatment for medically inoperable early stage non-small-cell lung cancer (NSCLC). Patients with ultracentral tumors (signifying tumors whose planning target volume touches or overlaps the central bronchial tree, esophagus, or pulmonary artery) may be at higher risk of serious toxicities such as bronchial stricture and collapse, esophageal strictures, tracheal-esophageal fistula, and hemorrhage. The primary objective of the study is to determine the maximum tolerated dose of radiotherapy for ultracentral NSCLC...
April 18, 2018: Clinical Lung Cancer
Donatella Caivano, Maurizio Valeriani, Sara De Matteis, Paolo Bonome, Ivana Russo, Vitaliana De Sanctis, Giuseppe Minniti, Mattia Falchetto Osti
BACKGROUND: The loco regional relapse is frequent in the lung disease. The aim of this study was to evaluate the outcomes of re-irradiation by SBRT in terms of Local Control (LC) and toxicities. METHODS: From April 2011 to December 2016, twenty-two patients received a re-irradiation by SBRT. Twenty- seven lesions were treated. The medium BED(10) of re-irradiation was 100.6 Gy (range: 48-151.2 Gy) and the medium EQD2(10) was 93.8 Gy (range: 40-126 Gy). In the previous treatment the medium BED(10) was 97...
May 8, 2018: Radiation Oncology
Kamran A Ahmed, Jacob G Scott, John A Arrington, Arash O Naghavi, G Daniel Grass, Bradford A Perez, Jimmy J Caudell, Anders E Berglund, Eric A Welsh, Steven A Eschrich, Thomas J Dilling, Javier F Torres-Roca
INTRODUCTION: We assessed the radiosensitivity of lung metastases based on primary histology using a validated gene signature and model lung metastases for the genomically adjusted radiation dose (GARD). METHODS: Tissue samples were identified from our prospective observational protocol. The radiosensitivity index (RSI) 10 gene assay was run on samples and calculated alongside GARD using the previously published algorithms. A cohort of 105 patients with 137 lung metastases treated with SBRT at our institution was used for clinical correlation...
May 4, 2018: Journal of Thoracic Oncology
Zachary D Horne, Michael J Dohopolski, David A Clump, Steven A Burton, Dwight E Heron
PURPOSE: Local failure following concurrent chemoradiation and in-lobe failures following stereotactic body radiation therapy (SBRT) are common. We evaluated our institutional experience using SBRT as salvage in this setting. METHODS AND MATERIALS: Seventy-two patients were reirradiated with SBRT for residual, locally recurrent, or new primary non-small cell lung cancer within or adjacent to a high-dose external beam radiation therapy or SBRT field. Kaplan-Meier analysis with log-rank test were used to estimate endpoints and differentiate cohorts...
May 2018: Practical Radiation Oncology
Takashi Shintani, Yukinori Matsuo, Yusuke Iizuka, Takamasa Mitsuyoshi, Takashi Mizowaki
PURPOSE: To assess the local recurrence (LR) rate and timing after stereotactic body radiation therapy (SBRT) for non-small cell lung cancer using long-term follow-up data from a single institution. METHODS AND MATERIALS: Patients with primary or recurrent non-small cell lung cancer with or without pathologic verification, with tumors <3 cm, treated with SBRT (isocenter prescription of 48 Gy in 4 fractions) between April 1998 and August 2014, and with >6 months' follow-up were eligible...
April 1, 2018: International Journal of Radiation Oncology, Biology, Physics
Takeaki Ishihara, Kazunari Yamada, Aya Harada, Haruhiro Yukiue, Masayuki Tanahashi, Hiroshi Niwa, Takashi Matsui, Koshi Yokomura, Yasuo Ejima, Ryohei Sasaki
BACKGROUND: The adaptation criteria for administration of stereotactic body radiotherapy (SBRT) to patients with lung cancer who previously underwent surgery and subsequently developed a second primary lung cancer (SPLC) or intra-parenchymal lung metastasis (IPLM) are controversial, unlike the criteria for repeat surgery. We aimed to evaluate the feasibility of SBRT for these patients. Factors associated with decreased respiratory function were also evaluated. MATERIAL AND METHODS: Sixty-nine patients with 89 lesions who underwent SBRT between 2008 and 2017 were analyzed...
May 3, 2018: Acta Oncologica
Filippo Alongi, Rosario Mazzola, Vanessa Figlia, Matthias Guckenberger
Exhaustive criteria and definitive data to identify the ideal lung oligometastatic patient as a candidate for stereotactic body radiotherapy (SBRT) are lacking. Three distinct cohorts of oligometastatic patients could be distinguished: (1) patients with upfront diagnosis of oligometastases (synchronous or metachronous); (2) patients with oligorecurrent disease in terms of relapsed oligometastatic phase; (3) oligoprogressive patients after cytoreductive treatment. The aim of the present review is to analyze available data concerning the efficacy/safety of SBRT for oligometastatic/oligoprogressive/oligorecurrent lung metastases...
April 1, 2018: Tumori
Benjamin J Seides, John P Egan, Kim D French, Kevin L Kovitz, Neeraj R Desai
Convex probe endobronchial ultrasound (CP-EBUS) and stereotactic body radiotherapy (SBRT) are valuable tools in the diagnosis, staging, and treatment of thoracic malignancies. With widespread clinical adoption, novel uses of CP-EBUS beyond mediastinal diagnosis and staging continue to be discovered. SBRT is an attractive treatment strategy in early-stage lung cancer and oligo-metastatic disease of the chest when a surgical approach is either not feasible or desirable. Accurate application of SBRT is aided by the placement of radio-opaque fiducial markers (FM) to compensate for respiratory cycle movements...
March 2018: Journal of Thoracic Disease
Adrien Paix, Georges Noel, Pierre-Emmanuel Falcoz, Pierre Levy
BACKGROUND: Projections estimate an increase of 50% of the incidence of lung cancer by 2030. Early-stage non-small cell lung cancer represented 19% of NSCLC cases diagnosed in the US between 2005 and 2011. There is rising evidence in favour of lung cancer screening, which will reduce the occurrence of later-stage lung cancers while raising the incidence of early-stage NSCLC. Current guidelines state that for early-stage NSCLC, surgical resection should be performed, and stereotactic body radiotherapy (SBRT) is an option for patients who are non-medically operable...
April 26, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Christopher H Chapman, Christopher McGuinness, Alexander R Gottschalk, Sue S Yom, Adam A Garsa, Mekhail Anwar, Steve E Braunstein, Atchar Sudhyadhom, Paul Keall, Martina Descovich
PURPOSE/OBJECTIVES: For lung stereotactic body radiation therapy (SBRT), real-time tumor tracking (RTT) allows for less radiation to normal lung compared to the internal target volume (ITV) method of respiratory motion management. To quantify the advantage of RTT, we examined the difference in radiation pneumonitis risk between these two techniques using a normal tissue complication probability (NTCP) model. MATERIALS/METHOD: 20 lung SBRT treatment plans using RTT were replanned with the ITV method using respiratory motion information from a 4D-CT image acquired at the original simulation...
April 26, 2018: Journal of Applied Clinical Medical Physics
Shaakir Hasan, Athanasios Colonias, Timothy Mickus, Matthew VanDeusen, Rodney E Wegner
BACKGROUND: There is emerging reliance on clinical imaging for the diagnosis, prognosis, and treatment evaluation of early stage non-small cell lung cancer (NSCLC) in patients deemed too high risk for biopsy. We report our experience of clinically diagnosed NSCLC treated empirically with stereotactic body radiotherapy (SBRT) to validate the imaging parameters used for management in this high-risk population. METHODS: We reviewed 101 empiric lung SBRT cases and profiled imaging specifics of computed tomography and positron emission tomography for diagnosis and follow-up...
April 26, 2018: Thoracic Cancer
Yasmin Korzets Ceder, Eyal Fenig, Aron Popvtzer, Nir Peled, Mordechai R Kramer, Milton Saute, Dima Bragilovsky, Tzippy Schochat, Aaron M Allen
BACKGROUND: SBRT is standard therapy for early stage lung cancer. Toxicity in central tumors has been a concern. RTOG 0813 showed that central SBRT is safe and effective. We report our experience with central SBRT. METHODS: We reviewed the records of patients treated with SBRT for central lung tumors (< 2 cm of the carina). Patients included primary lung cancer and recurrence following surgery and\ or conventional radiotherapy. All patients underwent 4DCT simulation and treatment planning was done with IMRT or VMAT techniques...
April 25, 2018: Radiation Oncology
Masaki Nakamura, Naoki Hashimoto, Hiroshi Mayahara, Haruka Uezono, Aya Harada, Ryo Nishikawa, Yoshiro Matsuo, Hiroki Kawaguchi, Hideki Nishimura
BACKGROUND: Oligo-recurrence has been considered to confer improved prognosis than other oligometastatic conditions, and stereotactic body radiation therapy (SBRT) is considered as an option of local therapy for lung or liver metastases. The purpose of this study was to investigate the efficacy and safety of SBRT for lung and liver oligo-recurrent lesions and evaluate predictive factors for local control and prognosis. METHODS: This retrospective study included patients who presented with 1-3 matachronous lung or liver metastases, and treated with SBRT between May 2013 and March 2016 at a single institution...
April 23, 2018: Radiation Oncology
Thahabah Alharthi, Elise M Pogson, Sankar Arumugam, Lois Holloway, David Thwaites
PURPOSE: To study the sensitivity of the ArcCHECK in detecting delivery errors for lung stereotactic body radiotherapy (SBRT) using the Volumetric Modulated Arc Therapy (VMAT) technique and to evaluate the sensitivity of eight global and local gamma tolerances with different cut-off percentages. METHODS: Baseline VMAT plans were generated for 15 lung SBRT patients. We delivered the smallest errors(gantry, collimator, and multileaf collimator MLC) which had ≥ ±2% dose difference in the modified treatment plans compared to the baseline plan (the clinical significance of those errors were assessed in our previous study...
April 20, 2018: Physica Medica: PM
Dongqi Li, Chuanchun He, Yaoxiong Xia, Yaxi Du, Jing Zhang
BACKGROUND: Pembrolizumab has significantly improved outcomes in patients with advanced non-small cell lung cancer. Combining programmed death-1 inhibitor with stereotactic body radiotherapy showed a slight toxicity and good benefits in recent clinical trials. However, patients infected with human immunodeficiency virus were excluded from most trials because it was assumed that their anti-tumor immunity was compromised compared with immunocompetent patients. CASE PRESENTATION: In June 2016, a 52-year-old Chinese man presented with human immunodeficiency virus and lung adenocarcinoma (T1bN3M1b)...
April 23, 2018: Journal of Medical Case Reports
Vivian Yau, Patricia Lindsay, Lisa Le, Anthea Lau, Olive Wong, Daniel Glick, Andrea Bezjak, B C John Cho, Andrew Hope, Alex Sun, Meredith Giuliani
PURPOSE: To explore and quantify the relationship between esophageal dose and toxicity in the setting of lung stereotactic body radiation therapy (SBRT). METHODS AND MATERIALS: This analysis was conducted on the basis of a prospective study of patients treated with SBRT at our institution from October 2004 to December 2015. Most patients were treated with 54 Gy/3 fractions, 48 Gy/4 fractions alternate days, or 60 Gy/8 fractions daily. Toxicity was prospectively graded using Common Terminology Criteria for Adverse Events version 3...
March 2, 2018: International Journal of Radiation Oncology, Biology, Physics
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