Efficiency of Stereotactic Conformal Radiotherapy in Lung Metastases with Active Breathing Control

Olga Yu. Anikeeva, PhD, Oxana A. Pashkovskaya*, Petr V. Filatov, Elena A. Samoilova, PhD.

Federal State Institute “Academician E.N. Meshalkin Novosibirsk State Research Institute of Circulation Pathology”, Novosibirsk, Russian Federation

*Corresponding author: Oxana A. Pashkovskaya. Center for radiosurgery and radiotherapy of Federal State Institute “Academician E.N. Meshalkin Novosibirsk State Research Institute of Circulation Pathology”. 15, Rechkunovskaya  st, Novosibirsk, 630058, Russian Federation. Tel: +79134882545. E-mail: oxana.pashkovskaya@gmail.com

Published: June 25, 2013

Abstract: 

Twenty four patients with lung metastases underwent radiosurgery treatment between October 2010 and December 2012. Stereotactic conformal high-dose radiation therapy with Active Breathing Control (ABC) was conducted using the volumetric modulated arc therapy (VMAT) technique. The median overall follow-up was 18 months (range 6-24 months), overall survival was 75%, and local control rate was 92%. The median time to progression was 4 months (range 1-18 months).There have been no cases of leucopenia, radiation esophagitis, mediastinitis or severe acute radiation pneumonitis. The late radiation effects Grade 2, according to the LENT SOMA scales, was observed in one patient (4%). The results of this study indicate that the usage of the stereotactic high-dose radiation therapy with ABC is safe and effective in the treatment of lung metastases.

Keywords: 
radiosurgery;stereotactic conformal radiotherapy; lung metastases; active breathing control.
References: 
  1. Ricardi U, Filippi AR, Guarneri A, Ragona R, Mantovani C, Giglioli F, et al. Stereotactic body radiation therapy for lung metastases. Lung Cancer 2012; 75(1):77-81.
  2. Wulf J, Haedinger U, Oppitz U, Thiele W, Mueller G, Flentje M. Stereotactic radiotherapy for primary lung cancer and pulmonary metastases: a noninvasive treatment approach in medically inoperable patients. Int J Radiat Oncol Biol Phys 2004; 60(1):186-96.
  3. Abratt RP, Bogart JA, Hunter A. Hypofractionated irradiation for non-small cell lung cancer. Lung Cancer 2002; 36(3):225-33.
  4. Brown WT, Wu X, Wen BC, Fowler JF, Fayad F, Amendola BE, et al. Early results of CyberKnife image-guided robotic stereotactic radiosurgery for treatment of lung tumors. Comput Aided Surg 2007; 12(5):253-61.
  5. Rusthoven KE, Kavanagh BD, Burri SH, Chen C, Cardenes H, Chidel MA, et al. Multi-institutional phase I/II trial of stereotactic body radiation therapy for lung metastases. J Clin Oncol 2009; 27(10):1579–84.
  6. Brock J, Ashley S, Bedford J, Nioutsikou E, Partridge M, Brada M. Review of hypofractionated small volume radiotherapy for early-stage non-small cell lung cancer. Clin Oncol (R Coll Radiol) 2008; 20(9):666-76.
  7. Schefter TE, Kavanagh BD, Raben D, Kane M, Chen C, Stuhr K, et al. A phase I/II trial of stereotactic body radiation therapy (SBRT) for lung metastases: Initial report of dose escalation and early toxicity. Int J Radiat Oncol Biol Phys 2006; 66:120–7.
  8. Timmerman R, McGarry R, Yiannoutsos C, Papiez L, Tudor K, DeLuca J, et al. Excessive toxicity when treating central tumors in a phase II study of stereotactic body radiation therapy for medically inoperable early-stage lung cancer. J Clin Oncol 2006; 24(30):4833-9.
  9. Giraud P, Yorke E, Ford EC, Wagman R, Mageras GS, Amols H, et al. Reduction of organ motion in lung tumors with respiratory gating. Lung Cancer 2006; 51(1):41-51.
  10. International Commission on Radiation Units and Measurements. ICRU report 50. Prescribing, recording, and reporting photon beam therapy. Bethesda, MD: International Commission on Radiation Units and Measurements; 1993.
  11. Hristov DH, Fallone BG. A grey-level image alignment algorithm for registration of portal images and digitally reconstructed radiographs. Med Phys 1996; 23(1):75–84.
  12. Vodicka J, Spidlen V, Simanek V, Safranek J, Skalicky T, Fichtl J, et al. Surgical therapy of pulmonary metastases - 10-year results. Bratisl Lek Listy 2013; 114(4):218-24.

The fully formatted PDF version is available.

Download Article

Int J Biomed. 2013; 3(2):78-80. © 2013 International Medical Research and Development Corporation. All rights reserved