Low rate of thoracic toxicity in palliative paraspinal single-fraction stereotactic body radiation therapy Journal Article
| Authors: | Gomez, D. R.; Hunt, M. A.; Jackson, A.; O'meara, W. P.; Bukanova, E. N.; Zelefsky, M. J.; Yamada, Y.; Rosenzweig, K. E. |
| Article Title: | Low rate of thoracic toxicity in palliative paraspinal single-fraction stereotactic body radiation therapy |
| Abstract: | Background: There has been an increase in the utilization of single-fraction stereotactic body radiation therapy (SBRT) to treat thoracic structures, but there have been few reports describing toxicity outcomes with this treatment. Methods: We evaluated 119 sites (114 patients) with no prior history of thoracic radiation were treated from 10/1/2003 to 10/27/2008 with single-fraction SBRT to thoracic structures. The median dose to the gross tumor volume was 2400 cGy (range 1800-2400 cGy), as was the median dose to the planning target volume (range 1600-2400 cGy). A detailed review of thoracic toxicities was performed to include pneumonitis or Grade 2 or higher esophageal and bronchial toxicity. In addition, we retrospectively contoured the esophagus and bronchus of 48 patients treated in 2004-2005, prior to the establishment of dose constraints to determine the range of doses that these structures received. Results: Of the contoured patients, the median dose to the hottest 1 cc (D1cc) of the esophagus was 1250 cGy (range 158-2572 cGy). The median bronchial D1cc was 1101 cGy (range 260-2211 cGy). At a median follow-up of 11.6 months, there were seven Grade 2 or higher esophageal toxicities, including one Grade 3 and one Grade 4 toxicities. There were two bronchial toxicities, one Grade 2 and one Grade 3. There were no cases of pneumonitis. Conclusions: High-dose single-fraction SBRT is well tolerated to the thoracic region, with most patients tolerating high doses to central structures without significant toxicity. © 2009. |
| Keywords: | cancer chemotherapy; controlled study; treatment outcome; major clinical study; erlotinib; radiation dose; palliative care; radiotherapy dosage; lung cancer; pneumonia; thoracic neoplasms; radiosurgery; lung; radiation injuries; bronchus; dose fractionation; stereotactic body radiation therapy; esophagus; hypofractionation; bronchus disease; esophagus disease; radiation sickness; thorax disease; bronchi; cough; deglutition disorders |
| Journal Title: | Radiotherapy and Oncology |
| Volume: | 93 |
| Issue: | 3 |
| ISSN: | 0167-8140 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2009-12-01 |
| Start Page: | 414 |
| End Page: | 418 |
| Language: | English |
| DOI: | 10.1016/j.radonc.2009.10.017 |
| PUBMED: | 19923027 |
| PROVIDER: | scopus |
| PMCID: | PMC2858382 |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 1" - "Export Date: 30 November 2010" - "CODEN: RAOND" - "Source: Scopus" |
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