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Lung Stereotactic Body Radiation Therapy (SBRT) dose gradient and PTV volume: a retrospective multi-center analysis.

ABSTRACT: BACKGROUND:The treatment of lung lesions with stereotactic body radiation therapy calls for highly conformal dose, which is evaluated by a number of metrics. Lung stereotactic body radiation therapy clinical trials constrain a plans gradient index. The purpose of this work is to describe the dependence of clinically achievable dose gradient on planning target volume. METHODS:Three hundred seventy-four lung stereotactic body radiation therapy treatment plans were retrospectively reviewed and selected for this study. The relationship between R50% and planning target volume size was observed and compared against the RTOG 0915 and 0813 constraints noting minor and major deviations. Then a least squares regression was used to determine the coefficients for a power functional form of the dependence of gradient measure (GM) on planning target volume size. RESULTS:Of the 317 peripheral lung SBRT plans, 142 exhibited no deviation, 135 exhibited a minor deviation, and 40 exhibited a major deviation according to the RTOG 0915 dosimetric. conformality and dose fall-off constraints. A plot of gradient measure versus planning target volume size for peripheral lesions, excluding RTOG 0915 major deviations, is fit with an power function of GM?=?0.564?V0.215. CONCLUSIONS:Using the PTV size and GM relationship we have characterized, treatment plans with PTV?

SUBMITTER: Hoffman D

PROVIDER: S-EPMC6724320 | biostudies-literature | 2019 Sep

REPOSITORIES: biostudies-literature

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Lung Stereotactic Body Radiation Therapy (SBRT) dose gradient and PTV volume: a retrospective multi-center analysis.

Hoffman David D Dragojević Irena I Hoisak Jeremy J Hoopes David D Manger Ryan R

Radiation oncology (London, England) 20190903 1

<h4>Background</h4>The treatment of lung lesions with stereotactic body radiation therapy calls for highly conformal dose, which is evaluated by a number of metrics. Lung stereotactic body radiation therapy clinical trials constrain a plans gradient index. The purpose of this work is to describe the dependence of clinically achievable dose gradient on planning target volume.<h4>Methods</h4>Three hundred seventy-four lung stereotactic body radiation therapy treatment plans were retrospectively re ...[more]

PMID: 31481089

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Project description:BackgroundTo investigate the effect of stereotactic body radiation therapy (SBRT) on pulmonary oligometastases and to analyze the clinical factors and dose parameters affecting local recurrence-free survival (LRFS) and overall survival (OS).MethodsThis study retrospectively enrolled a total of 84 patients (148 lesions) treated in our department from May 2015 to November 2018. Pulmonary oligometastases was defined as up to 5 metastatic lesions in the lung and with both the primary tumor and any extra-thoracic metastases being controlled. Patients receiving a BED10 (biological effective dose, α/β =10) of SBRT ≥75 Gy and a dose/fraction ≥4 Gy were enrolled. The patient group consisted of 52 men (61.9%) and 32 women (38.1%), with a median age 56 years (range, 29-80 years). Median tumor diameter was 1.71cm (range, 1.2-5.0 cm). The BED10 was 75-119 Gy in 4-15 fractions. Univariate and multivariate Cox regression analyses were performed on factors predicting the outcomes.ResultsAll patients completed the treatment as planned, and the median follow-up time was 20.3 months. The median OS for the entire group was 34.3 months, with an actuarial 1-, 2-, 3- and 5-year OS of 74.7%, 59.4%, 49.7%, and 36.8%, respectively. Among the 148 lesions in the whole group, 19 (12.8%) lesions had local recurrence (LR). The median LRFS time for all patients was 56.9 months. The LRFS rate was 93.6%, 83.5%, 81.4%, and 76.6% at 1, 2, 3, and 5 years, respectively. No patient developed acute grade 3 or 4 toxicity. On univariate analysis, age ≥63 years old, primary site of colorectal cancer, BED10 <85.2 Gy, pathological type of adenocarcinoma, planning target volume (PTV) min BED10 <76.6 Gy, and gross tumor volume (GTV) ≥8.8 cc, were significantly associated with poorer LRFS. Multivariate analysis showed that age ≥63 years old, primary site of colorectal cancer, and PTV min BED10 <76.6 Gy were significant risk factors affecting LRFS.ConclusionsSBRT is feasible for pulmonary oligometastasis with favorable local control and minimal toxicity. Multiple dose parameters, instead of a prescription dose only, in combination with clinical parameters, should be considered for optimal local control.

Dataset Information

Lung Stereotactic Body Radiation Therapy (SBRT) dose gradient and PTV volume: a retrospective multi-center analysis.

Publications

Lung Stereotactic Body Radiation Therapy (SBRT) dose gradient and PTV volume: a retrospective multi-center analysis.

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