Title |
Establishing stereotactic body radiotherapy with flattening filter free techniques in the treatment of pulmonary lesions - initial experiences from a single institution
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Published in |
Radiation Oncology, June 2016
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DOI | 10.1186/s13014-016-0648-0 |
Pubmed ID | |
Authors |
Juliane Rieber, Eric Tonndorf-Martini, Oliver Schramm, Bernhard Rhein, Laila König, Sebastian Adeberg, Eva Meyerhof, Angela Mohr, Jutta Kappes, Hans Hoffmann, Jürgen Debus, Stefan Rieken |
Abstract |
Stereotactic body radiotherapy (SBRT) using flattening filter free (FFF)-techniques has been increasingly applied during the last years. However, clinical studies investigating this emerging technique are still rare. Hence, we analyzed toxicity and clinical outcome of pulmonary SBRT with FFF-techniques and performed dosimetric comparison to conventional techniques using flattening filters (FF). Between 05/2014 and 06/2015, 56 consecutive patients with 61 pulmonary lesions were treated with SBRT in FFF-mode. Central lesions received 8 × 7.5 Gy delivered to the conformally enclosing 80 %-isodose, while peripheral lesions were treated with 3 × 15 Gy, prescribed to the 65 %-isodose. Early and late toxicity (after 6 months) as well as initial clinical outcomes were evaluated. Furthermore, [deleted] plan quality and efficiency were evaluated by analyzing conformity, beam- on and total treatment delivery times in comparison to plans with FF-dose application. Median follow-up time was 9.3 months (range 1.5-18.0 months). Early toxicity was low with only 5 patients (8.9 %) reporting CTCAE 2° or higher side-effects. Only one patient (1.8 %) was diagnosed with radiation-induced pneumonitis CTCAE 3°, while 2 (3.6 %) patients suffered from pneumonitis CTCAE 2°. After 6 months, no toxicity greater than CTCAE 2° was reported. 1-year local progression-free survival, distant progression-free survival and overall survival were 92.8 %, 78.0 %, and 94.4 %, respectively. While plan quality was similar for FFF- and FF-plans in respect to conformity (p = 0.275), median beam-on time as well as total treatment time were significantly reduced for SBRT in FFF-mode compared to FF-mode (p ≤ 0.001, p ≤ 0.001). Patient treatment with SBRT using FFF-techniques is safe and provides promising clinical results with only modest toxicity at significantly increased dose delivery speed. |
Mendeley readers
Geographical breakdown
Country | Count | As % |
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Unknown | 30 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
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Student > Bachelor | 5 | 17% |
Student > Master | 4 | 13% |
Other | 3 | 10% |
Researcher | 3 | 10% |
Student > Ph. D. Student | 2 | 7% |
Other | 3 | 10% |
Unknown | 10 | 33% |
Readers by discipline | Count | As % |
---|---|---|
Physics and Astronomy | 6 | 20% |
Medicine and Dentistry | 5 | 17% |
Nursing and Health Professions | 5 | 17% |
Chemical Engineering | 1 | 3% |
Social Sciences | 1 | 3% |
Other | 1 | 3% |
Unknown | 11 | 37% |