Stereotactic body radiation therapy of lung tumors: Preliminary experience using normal tissue complication probability-based dose limits

Danny Y. Song, Stanley H Benedict, Robert M. Cardinale, Theodore D. Chung, Michael G. Chang, Rupert K. Schmidt-Ullrich

Research output: Contribution to journalArticle

40 Scopus citations

Abstract

Objectives: To assess the feasibility and toxicity of stereotactic body radiotherapy (SBRT) for patients with locally advanced or metastatic tumors in lung. Methods: Twenty-five tumors in 17 patients were treated. All treatments were delivered in 3 daily fractions of 9 to 15 Gy per fraction. Normal tissue complication probability (NTCP) calculations (using the Lyman model) were performed to facilitate dose prescription, and doses were prescribed with a maximum allowable NTCP risk of pneumonitis of up to 20%, not to exceed 15 Gy per fraction. Planning target volumes were designed to allow for respiratory variation in tumor location. Results: The median dose prescribed was 35 Gy (range, 24 to 45 Gy). Twenty-three of 25 tumors remained controlled at median follow-up of 14 months. Four patients experienced grade 1-2 acute toxicity. Late toxicity developed in 2 patients who received treatment to peri-hilar tumors, including one patient in whom bronchial stenosis developed with complete occlusion and lobar atelectasis 6 months after treatment. No patient had grade 3 or 4 radiation pneumonitis. Conclusions: SBRT prescribed within the confines of NTCP-restricted dosing on this protocol resulted in no radiation pneumonitis. Tissues other than lung parenchyma which are unaccounted for by NTCP may be dose-limiting when performing hypofractionated SBRT in the lung.

Original languageEnglish (US)
Pages (from-to)591-596
Number of pages6
JournalAmerican Journal of Clinical Oncology: Cancer Clinical Trials
Volume28
Issue number6
DOIs
StatePublished - Dec 2005
Externally publishedYes

Keywords

  • Extracranial radiosurgery
  • Lung
  • Normal tissue complication probability
  • Stereotactic body radiotherapy

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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