Early pulmonary toxicity following lung stereotactic body radiation therapy delivered in consecutive daily fractions

Radiother Oncol. 2011 May;99(2):166-71. doi: 10.1016/j.radonc.2011.04.002. Epub 2011 May 14.

Abstract

Background and purpose: Identify the incidence of early pulmonary toxicity in a cohort of patients treated with lung stereotactic body radiation therapy (SBRT) on consecutive treatment days.

Material and methods: A total of 88 lesions in 84 patients were treated with SBRT in consecutive daily fractions (Fx) for medically inoperable non-small cell lung cancer or metastasis. The incidence of pneumonitis was evaluated and graded according to the NCI CTCAE v3.0.

Results: With a median follow-up of 15.8 months (range 2.5-28.6), the median age at SBRT was 71.8 years (range 23.8-87.8). 47 lesions were centrally located and 41 were peripheral. Most central lesions were treated with 48Gy in 4 Fx, and most peripheral lesions with 54Gy in 3 Fx. The incidence of grade ≥ 2 pneumonitis was 12.5% in all patients treated, and 14.3% among the subset of patients treated with 54Gy in 3 Fx. A total of two grade 3 toxicities were seen as one grade 5 toxicity in a patient treated for recurrence after pneumonectomy.

Conclusions: Treating both central and peripheral lung lesions with SBRT in consecutive daily fractions in this cohort was well tolerated and did not cause excessive early pulmonary toxicity.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Non-Small-Cell Lung / diagnostic imaging
  • Carcinoma, Non-Small-Cell Lung / pathology
  • Carcinoma, Non-Small-Cell Lung / surgery*
  • Cone-Beam Computed Tomography
  • Dose Fractionation, Radiation
  • Follow-Up Studies
  • Humans
  • Incidence
  • Lung Neoplasms / diagnostic imaging
  • Lung Neoplasms / pathology
  • Lung Neoplasms / surgery*
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Pneumonectomy
  • Proportional Hazards Models
  • Prospective Studies
  • Radiation Pneumonitis / epidemiology*
  • Radiosurgery / methods*
  • Registries
  • Survival Rate
  • Treatment Outcome