Volumetric modulated arc therapy with flattening filter free (FFF) beams for stereotactic body radiation therapy (SBRT) in patients with medically inoperable early stage non small cell lung cancer (NSCLC)

Research output: Contribution to journalArticle

Abstract

Purpose To assess the impact of volumetric modulated arc therapy (VMAT) with flattening filter free (FFF) beams for stereotactic body radiotherapy (SBRT) in inoperable stage I NSCLC. Current data were compared against a cohort of patients previously treated with advanced conformal techniques (3DCRT) based on conformal arcs. Methods and materials From July 2006 to December 2011 132 patients underwent SBRT, 86 by 3DCRT with flattened beams (FF), while the last 46 with VMAT RapidArc and unflattened beams (FFF). All patients were treated with 48 Gy in four fractions of 12 Gy each. Patients underwent follow-up. Clinical outcome was evaluated with thoracic and abdominal CT scan and 18FDG-CTPET before and after treatment. Results Both techniques achieved adequate dose conformity to the target but with a statistically significant reduction of ipsilateral lung doses in RapidArc plans and also of Beam-on-Time (BOT) with FFF mode. The median follow up was 16 months (range 2-24 months). At 1 year, local control rate was 100% with FFF beams compared with 92.5% with FF beams (p = 0.03). Conclusions SBRT with FFF beams permitted us a safe delivery of high dose per fraction in a short treatment time and resulted in an earlier radiological response compared with FF beams.

Original languageEnglish
Pages (from-to)414-418
Number of pages5
JournalRadiotherapy and Oncology
Volume107
Issue number3
DOIs
Publication statusPublished - Jun 2013

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Intensity-Modulated Radiotherapy
Non-Small Cell Lung Carcinoma
Radiotherapy
Radiosurgery
Fluorodeoxyglucose F18
Thorax
Lung
Therapeutics

Keywords

  • NSCLC
  • SBRT
  • Volumetric modulated Arc Therapy

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Hematology

Cite this

@article{8a7d5cc4b3f74ee3a4303f7a5c7cbf9a,
title = "Volumetric modulated arc therapy with flattening filter free (FFF) beams for stereotactic body radiation therapy (SBRT) in patients with medically inoperable early stage non small cell lung cancer (NSCLC)",
abstract = "Purpose To assess the impact of volumetric modulated arc therapy (VMAT) with flattening filter free (FFF) beams for stereotactic body radiotherapy (SBRT) in inoperable stage I NSCLC. Current data were compared against a cohort of patients previously treated with advanced conformal techniques (3DCRT) based on conformal arcs. Methods and materials From July 2006 to December 2011 132 patients underwent SBRT, 86 by 3DCRT with flattened beams (FF), while the last 46 with VMAT RapidArc and unflattened beams (FFF). All patients were treated with 48 Gy in four fractions of 12 Gy each. Patients underwent follow-up. Clinical outcome was evaluated with thoracic and abdominal CT scan and 18FDG-CTPET before and after treatment. Results Both techniques achieved adequate dose conformity to the target but with a statistically significant reduction of ipsilateral lung doses in RapidArc plans and also of Beam-on-Time (BOT) with FFF mode. The median follow up was 16 months (range 2-24 months). At 1 year, local control rate was 100{\%} with FFF beams compared with 92.5{\%} with FF beams (p = 0.03). Conclusions SBRT with FFF beams permitted us a safe delivery of high dose per fraction in a short treatment time and resulted in an earlier radiological response compared with FF beams.",
keywords = "NSCLC, SBRT, Volumetric modulated Arc Therapy",
author = "Pierina Navarria and Ascolese, {Anna Maria} and Pietro Mancosu and Filippo Alongi and Elena Clerici and Angelo Tozzi and Cristina Iftode and Giacomo Reggiori and Stefano Tomatis and Maurizio Infante and Marco Alloisio and Alberto Testori and Antonella Fogliata and Luca Cozzi and Emanuela Morenghi and Marta Scorsetti",
year = "2013",
month = "6",
doi = "10.1016/j.radonc.2013.04.016",
language = "English",
volume = "107",
pages = "414--418",
journal = "Radiotherapy and Oncology",
issn = "0167-8140",
publisher = "Elsevier Ireland Ltd",
number = "3",

}

TY - JOUR

T1 - Volumetric modulated arc therapy with flattening filter free (FFF) beams for stereotactic body radiation therapy (SBRT) in patients with medically inoperable early stage non small cell lung cancer (NSCLC)

AU - Navarria, Pierina

AU - Ascolese, Anna Maria

AU - Mancosu, Pietro

AU - Alongi, Filippo

AU - Clerici, Elena

AU - Tozzi, Angelo

AU - Iftode, Cristina

AU - Reggiori, Giacomo

AU - Tomatis, Stefano

AU - Infante, Maurizio

AU - Alloisio, Marco

AU - Testori, Alberto

AU - Fogliata, Antonella

AU - Cozzi, Luca

AU - Morenghi, Emanuela

AU - Scorsetti, Marta

PY - 2013/6

Y1 - 2013/6

N2 - Purpose To assess the impact of volumetric modulated arc therapy (VMAT) with flattening filter free (FFF) beams for stereotactic body radiotherapy (SBRT) in inoperable stage I NSCLC. Current data were compared against a cohort of patients previously treated with advanced conformal techniques (3DCRT) based on conformal arcs. Methods and materials From July 2006 to December 2011 132 patients underwent SBRT, 86 by 3DCRT with flattened beams (FF), while the last 46 with VMAT RapidArc and unflattened beams (FFF). All patients were treated with 48 Gy in four fractions of 12 Gy each. Patients underwent follow-up. Clinical outcome was evaluated with thoracic and abdominal CT scan and 18FDG-CTPET before and after treatment. Results Both techniques achieved adequate dose conformity to the target but with a statistically significant reduction of ipsilateral lung doses in RapidArc plans and also of Beam-on-Time (BOT) with FFF mode. The median follow up was 16 months (range 2-24 months). At 1 year, local control rate was 100% with FFF beams compared with 92.5% with FF beams (p = 0.03). Conclusions SBRT with FFF beams permitted us a safe delivery of high dose per fraction in a short treatment time and resulted in an earlier radiological response compared with FF beams.

AB - Purpose To assess the impact of volumetric modulated arc therapy (VMAT) with flattening filter free (FFF) beams for stereotactic body radiotherapy (SBRT) in inoperable stage I NSCLC. Current data were compared against a cohort of patients previously treated with advanced conformal techniques (3DCRT) based on conformal arcs. Methods and materials From July 2006 to December 2011 132 patients underwent SBRT, 86 by 3DCRT with flattened beams (FF), while the last 46 with VMAT RapidArc and unflattened beams (FFF). All patients were treated with 48 Gy in four fractions of 12 Gy each. Patients underwent follow-up. Clinical outcome was evaluated with thoracic and abdominal CT scan and 18FDG-CTPET before and after treatment. Results Both techniques achieved adequate dose conformity to the target but with a statistically significant reduction of ipsilateral lung doses in RapidArc plans and also of Beam-on-Time (BOT) with FFF mode. The median follow up was 16 months (range 2-24 months). At 1 year, local control rate was 100% with FFF beams compared with 92.5% with FF beams (p = 0.03). Conclusions SBRT with FFF beams permitted us a safe delivery of high dose per fraction in a short treatment time and resulted in an earlier radiological response compared with FF beams.

KW - NSCLC

KW - SBRT

KW - Volumetric modulated Arc Therapy

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U2 - 10.1016/j.radonc.2013.04.016

DO - 10.1016/j.radonc.2013.04.016

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