TY  - JOUR
AU  - Tian, Sibo
AU  - Switchenko, Jeffrey M.
AU  - Cassidy, Richard J.
AU  - Escott, Chase E.
AU  - Castillo, Richard
AU  - Patel, Pretesh R.
AU  - Curran, Walter J.
AU  - Higgins, Kristin A.
PY  - 2018
TI  - Predictors of pneumonitis-free survival following lung stereotactic body radiation therapy
JF  - Translational Lung Cancer Research; Vol 8, No 1 (February 01, 2019): Translational Lung Cancer Research (Stereotactic Body Radiation Therapy for Thoracic Malignancies)
Y2  - 2018
KW  - 
N2  -  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.
UR  - https://tlcr.amegroups.org/article/view/24942