%0 Journal Article %T Predictors of pneumonitis-free survival following lung stereotactic body radiation therapy %A Tian, Sibo %A Switchenko, Jeffrey M. %A Cassidy, Richard J. %A Escott, Chase E. %A Castillo, Richard %A Patel, Pretesh R. %A Curran, Walter J. %A Higgins, Kristin A. %J Translational Lung Cancer Research %D 2018 %B 2018 %9 %! Predictors of pneumonitis-free survival following lung stereotactic body radiation therapy %K %X Background: Radiation pneumonitis is a common toxicity following lung stereotactic body radiation therapy (SBRT). We explored whether motion management technique, in conjunction with patient and treatment characteristics, is a predictor of radiation pneumonitis-free survival (PNFS). Methods: A single institution multi-center lung SBRT database was retrospectively reviewed. PNFS was defined as time to earliest onset of radiation pneumonitis or last clinical follow-up. Patients were simulated using a 4-dimensional approach, and those with 1 cm or greater tumor motion were selected for respiratory-gated treatment. Real-time Position Management and phase-based gating were employed. Univariate and multivariable Cox proportional hazard models were fit for relevant covariates to determine the impact of free-breathing versus respiratory-gated treatment on PNFS. Results: The initial treatment courses of 208 patients were included, with a median follow-up length of 23 months. The median age at treatment was 71 years. About 91.8% of patient had early stage (T1–2) non-small cell lung cancer and were treated with common regimens including 10 Gy ×5, 12 Gy ×4 and 18 Gy ×3; 26.4% underwent respiratory-gated SBRT. The overall rate of grade 3 or higher radiation pneumonitis was 10.1%. PNFS was not significantly different between patients treated with respiratory-gated versus free-breathing SBRT (HR =0.88; P=0.707); tumor location and fractionation were predictors of PNFS in the multivariate setting. Conclusions: The method of motion management does not appear to impact PNFS when the tolerance for tumor displacement is 1 cm or less for free-breathing treatment planning and delivery. This approach may be appropriate when selecting patients for respiratory gating. %U https://tlcr.amegroups.org/article/view/24942 %V 8 %N 1 %P 15-23 %@ 2226-4477