Acute skin toxicity following stereotactic body radiation therapy for stage I non-small-cell lung cancer: Who's at risk? Journal Article
| Authors: | Hoppe, B. S.; Laser, B.; Kowalski, A. V.; Fontenla, S. C.; Pena-Greenberg, E.; Yorke, E. D.; Lovelock, D. M.; Hunt, M. A.; Rosenzweig, K. E. |
| Article Title: | Acute skin toxicity following stereotactic body radiation therapy for stage I non-small-cell lung cancer: Who's at risk? |
| Abstract: | Purpose: We examined the rate of acute skin toxicity within a prospectively managed database of patients treated for early-stage non-small-cell lung cancer (NSCLC) and investigated factors that might predict skin toxicity. Methods: From May 2006 through January 2008, 50 patients with Stage I NSCLC were treated at Memorial Sloan-Kettering Cancer Center with 60 Gy in three fractions or 44-48 Gy in four fractions. Patients were treated with multiple coplanar beams (3-7, median 4) with a 6 MV linac using intensity-modulated radiotherapy (IMRT) and dynamic multileaf collimation. Toxicity grading was performed and based on the National Cancer Institute Common Terminology Criteria for Adverse Effects. Factors associated with Grade 2 or higher acute skin reactions were calculated by Fisher's exact test. Results: After a minimum 3 months of follow-up, 19 patients (38%) developed Grade 1, 4 patients (8%) Grade 2, 2 patients (4%) Grade 3, and 1 patient Grade 4 acute skin toxicity. Factors associated with Grade 2 or higher acute skin toxicity included using only 3 beams (p = 0.0007), distance from the tumor to the posterior chest wall skin of less than 5 cm (p = 0.006), and a maximum skin dose of 50% or higher of the prescribed dose (p = 0.02). Conclusions: SBRT can be associated with significant skin toxicity. One must consider the skin dose when evaluating the treatment plan and consider the bolus effect of immobilization devices. © 2008 Elsevier Inc. All rights reserved. |
| Keywords: | adult; clinical article; controlled study; aged; intensity modulated radiation therapy; skin toxicity; cancer radiotherapy; radiation dose; cancer staging; follow up; follow-up studies; neoplasm staging; lung non small cell cancer; carcinoma, non-small-cell lung; lung neoplasms; radiotherapy dosage; radiotherapy; lung cancer; patient monitoring; radiation injury; necrosis; risk assessment; skin; physical therapy; radiotherapy, intensity-modulated; radiosurgery; stereotactic treatment; collimator; toxicity; stereotactic body radiation therapy; biological organs; intensity-modulated radiation therapy; rate constants; patient care planning; image-guided radiation therapy; terminology; whole body autoradiography |
| Journal Title: | International Journal of Radiation Oncology, Biology, Physics |
| Volume: | 72 |
| Issue: | 5 |
| ISSN: | 0360-3016 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2008-12-01 |
| Start Page: | 1283 |
| End Page: | 1286 |
| Language: | English |
| DOI: | 10.1016/j.ijrobp.2008.08.036 |
| PUBMED: | 19028267 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 24" - "Export Date: 17 November 2011" - "CODEN: IOBPD" - "Source: Scopus" |
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
Related MSK Work