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Pulmonary function in stereotactic body radiotherapy with helical tomotherapy for primary and metastatic lung lesions

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Abstract

Aims

This retrospective study reports outcomes after stereotactic body radiation therapy (SBRT) as delivered by helical tomotherapy (HT) for lung lesions. It promotes a dose escalation program.

Methods

Histological and/or radiological findings and/or case histories identified 41 primary and 15 metastatic lesions. Thirty patients received 40 Gy in 5 fractions (BED 72 Gy10Gy) and 26 50 Gy in 5 fractions (BED 100Gy10Gy). Primary end point was lung toxicity. Secondary end points were respiratory function, local control and local progression-free survival.

Results

Acute toxicity developed in 18/56 patients and late toxicity in 8/54. Median FEV-1 variations versus baseline were − 0.5% (range − 16 to + 43%) at 6 months and − 4.00% (range − 42 to + 18%) at 24 months. Median DLCO variations versus baseline were − 1% (range − 38 to + 36%) at 6 months and − 12.2% (range − 48 to + 11%) at 24 months. At 6 months, a significant positive correlation emerged between FEV-1 change and KPS (p = 0.047). At 24 months, a significant negative correlation emerged between FEV-1 change and the ipsilateral lung V5 (p = 0.006). A low baseline DLCO correlated with more marked DLCO worsening at 6 months (p = 0.012). At 24 months, DLCO worsening correlated significantly with the median contralateral lung dose (p = 0.003). At the last checkup, 23 patients were in complete remission, 16 were in partial remission, 5 had stable disease, and 7 were in relapse. Median follow-up was 12 months (range 5–56).

Conclusions

In patients with lung disease, SBRT, as delivered by HT, was well tolerated and provided good local control.

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Authors and Affiliations

  1. Radiation Oncology Section, Perugia General Hospital, Perugia, Italia

    Lorenzo Falcinelli, Rita Bellavita & Simonetta Saldi

  2. Radiation Oncology Unit, University of Perugia, Perugia, Italia

    Monia Mendichi, Sara Chierchini & Maria Valentina Tenti

  3. Radiation Oncology Unit, University of Perugia and Perugia General Hospital, Perugia, Italia

    Gianluca Ingrosso & Cynthia Aristei

  4. Medical Physics Section, Perugia General Hospital, Perugia, Italia

    Valentina Reggioli

  5. Endocrine and Metabolic Science Unit, University of Perugia, Perugia, Italia

    Vittorio Bini

Authors
  1. Lorenzo Falcinelli
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  2. Monia Mendichi
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  3. Sara Chierchini
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  4. Maria Valentina Tenti
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  5. Rita Bellavita
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  6. Simonetta Saldi
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  7. Gianluca Ingrosso
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  8. Valentina Reggioli
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  9. Vittorio Bini
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  10. Cynthia Aristei
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Contributions

All the authors have made substantial contribution to the conception and design of the study.

Corresponding author

Correspondence to Sara Chierchini.

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Conflict of interest

All the authors declare that there do not exist actual or potential conflicts of interest. This study was not supported by any grants whatsoever.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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This article does not contain any studies with animals performed by any of the authors.

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Falcinelli, L., Mendichi, M., Chierchini, S. et al. Pulmonary function in stereotactic body radiotherapy with helical tomotherapy for primary and metastatic lung lesions. Radiol med 126, 163–169 (2021). https://doi.org/10.1007/s11547-020-01223-w

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  • DOI: https://doi.org/10.1007/s11547-020-01223-w

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