TY - JOUR
T1 - Lung optimized treatment with cyberknife® in inoperable lung cancer patients
T2 - Feasibility analysis of a mono-institutional 115 patient series
AU - Francia, C. M.
AU - Marvaso, G.
AU - Piperno, G.
AU - Gandini, S.
AU - Ferrari, A.
AU - Zerella, M. A.
AU - Arculeo, S.
AU - Sibio, D.
AU - Fodor, C.
AU - Pepa, M.
AU - Trivellato, S.
AU - Rondi, E.
AU - Vigorito, S.
AU - Cattani, F.
AU - Spaggiari, L.
AU - Marinis, F. De
AU - Orecchia, R.
AU - Ciardo, D.
AU - Jereczek-Fossa, B. A.
N1 - Funding Information:
Acknowledgments: This work was partially supported by a research grant from Accuray Inc. entitled “Data collection and analysis of Tomotherapy and CyberKnife breast clinical studies, breast physics studies and prostate study”. The Sponsor did not play any role in the study design, collection, analysis, and interpretation of data, nor in the writing of the manuscript, or in the decision to submit the manuscript for publication.
Publisher Copyright:
© 2020, AEPress, s.r.o.. All rights reserved.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020
Y1 - 2020
N2 - CyberKnife® Lung Optimized Treatment (LOT) allows the treatment of lung cancer without invasive fiducial implanta-tion. The aim of this retrospective analysis was to evaluate the feasibility, toxicity and clinical outcome. One hundred fifteen patients (124 lesions) were treated with CyberKnife® using LOT. The median age was 72.6 years (range 31.8–90.3). From 124 treated lesions, 52 were with histopathological confirmation (41 primitive pulmonary cancers, 8 pulmonary metastases) and 72 as untyped tumors. For 5 patients (6 lesions) treatment was an in-field re-irradiation. Concomitant therapy was administered in 7 patients. Zero-View tracking was applied in 69 patients, 1-View in 33 patients, 2-View in 22 patients. The median total dose was 45 Gy (range 18–54), median dose/fraction was 15 Gy (range 4–18) with a median prescription isodose of 80% (range 68–85). The median planning target volume (PTV) was 25 cm3 (range 3–195). The median follow-up was 20 months (range 7–47). Thirty-seven patients (32%) were alive with no evidence of disease, 39 patients (34%) were alive with clinically evident disease, and 38 patients (33%) died of the disease. The 1-and 2-year overall survival (OS) rate was 83% and 61%. The median time to progression was 19 months (95% confidence interval: 11–19 months), 1-and 2-year progression-free survival (PFS) rates were 62% and 41%, respectively. Smaller PTV was significantly associated with better OS, PFS and in-field PFS in univariate and multivariate analyses. Acute toxicity was observed in 36 patients (41%). Late toxicity was registered in 25 patients (29%). G3 late toxicity was observed in one patient (1.1%). Our data suggest that fiducial less-stereotactic body radiation therapy (SBRT) is a feasible, well-tolerated and potentially effective treatment with high compliance in the setting of inoperable patients due to concomitant disease or previous treatments.
AB - CyberKnife® Lung Optimized Treatment (LOT) allows the treatment of lung cancer without invasive fiducial implanta-tion. The aim of this retrospective analysis was to evaluate the feasibility, toxicity and clinical outcome. One hundred fifteen patients (124 lesions) were treated with CyberKnife® using LOT. The median age was 72.6 years (range 31.8–90.3). From 124 treated lesions, 52 were with histopathological confirmation (41 primitive pulmonary cancers, 8 pulmonary metastases) and 72 as untyped tumors. For 5 patients (6 lesions) treatment was an in-field re-irradiation. Concomitant therapy was administered in 7 patients. Zero-View tracking was applied in 69 patients, 1-View in 33 patients, 2-View in 22 patients. The median total dose was 45 Gy (range 18–54), median dose/fraction was 15 Gy (range 4–18) with a median prescription isodose of 80% (range 68–85). The median planning target volume (PTV) was 25 cm3 (range 3–195). The median follow-up was 20 months (range 7–47). Thirty-seven patients (32%) were alive with no evidence of disease, 39 patients (34%) were alive with clinically evident disease, and 38 patients (33%) died of the disease. The 1-and 2-year overall survival (OS) rate was 83% and 61%. The median time to progression was 19 months (95% confidence interval: 11–19 months), 1-and 2-year progression-free survival (PFS) rates were 62% and 41%, respectively. Smaller PTV was significantly associated with better OS, PFS and in-field PFS in univariate and multivariate analyses. Acute toxicity was observed in 36 patients (41%). Late toxicity was registered in 25 patients (29%). G3 late toxicity was observed in one patient (1.1%). Our data suggest that fiducial less-stereotactic body radiation therapy (SBRT) is a feasible, well-tolerated and potentially effective treatment with high compliance in the setting of inoperable patients due to concomitant disease or previous treatments.
KW - CyberKnife Lung Optimized Treatment
KW - Fiducial-less SBRT
KW - Lung cancer
KW - Stereotactic radiotherapy
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UR - http://www.scopus.com/inward/citedby.url?scp=85084926595&partnerID=8YFLogxK
U2 - 10.4149/neo_2020_190717N645
DO - 10.4149/neo_2020_190717N645
M3 - Article
C2 - 32182088
AN - SCOPUS:85084926595
VL - 67
SP - 684
EP - 691
JO - Neoplasma
JF - Neoplasma
SN - 0028-2685
IS - 3
ER -