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Stereotactic body radiotherapy for cardiac and paracardiac metastases: University of Florence experience

Radioterapia stereotassica extracranica per metastasi cardiache e paracardiache: esperienza dell’Università di Firenze

  • Radiotherapy / Radioterapia
  • Published:
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Abstract

Purpose

This study sought to evaluate acute toxicity and local control in patients who underwent extracranial stereotactic body radiation therapy (SBRT) for paracardiac and cardiac metastatic lesions, defined as such when located at a maximum distance of 1 cm from the heart or inside its parenchyma.

Materials and methods

Between January 2009 and May 2011, 16 patients with paracardiac and cardiac lesions were treated with SBRT. For dose specification, in 15 of 16 patients, the prescription dosage was 36 Gy in three fractions (70% isodose). In one patient, the target lesion was inside the heart, and the prescription dosage was 30 Gy in three fractions (70% isodose).

Results

Regarding response to stereotactic radiotherapy, we recorded one (6%) complete response (CR), six (37%) partial responses (PR), five (32%) stable disease (SD) and four (25%) local failures. Median interval to local failure was 5.2 (range, 3–12) months. The cause of death was distant progression of disease in all four patients. Compliance to treatment was excellent; no patient developed cardiological symptoms or electrocardiographic abnormalities, even months after SBRT.

Conclusions

Results of our retrospective study indicate that SBRT represents a safe and effective treatment option for patients with cardiac and paracardiac metastases.

Riassunto

Obiettivo

Scopo di questo lavoro è valutare la tossicità acuta e il controllo locale nel trattamento di pazienti sottoposti a radioterapia stereotassica extracranica (SBRT) per lesioni metastatiche paracardiache e cardiache, definite come tali se localizzate entro 1 cm dal cuore o nel contesto del suo parenchima

Materiali e metodi

Fra gennaio 2009 e maggio 2011, 16 pazienti con lesioni paracardiache e cardiache sono stati sottoposti a SBRT. In 15/16 pazienti la dose prescritta è stata di 36 Gy in 3 frazioni (all’isodose del 70%). In un paziente la lesione target era intracardiaca, e la dose di prescrizione è stata di 30 Gy in 3 frazioni (all’isodose del 70%).

Risultati

Per quanto concerne la risposta alla radioterapia stereotassica, è stata registrata 1 (6%) risposta completa (CR), 6 (37%) risposte parziali (PR), 5 (32%) stabilità di malattia (SD) e 4 (25%) progressioni locali. L’intervallo mediano alla progressione locale è stato di 5,2 mesi (range 3–12 mesi). La tolleranza al trattamento è stata ottimale; nella serie di pazienti trattati nessuno ha sviluppato segni o sintomi di natura cardiologica in conseguenza della SBRT.

Conclusioni

I risultati della nostra analisi retrospettiva indicano che la SBRT rappresenta una opzione terapeutica sicura ed efficace per metastasi cardiache e paracardiache.

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Authors and Affiliations

  1. Santa Chiara Radiotherapy Unit, Florence University, Via di Barbiano 2A, 50129, Florence, Italy

    Pierluigi Bonomo, Lorenzo Livi, Andrea Rampini, Ivano Bonucci, Laura Masi & Raffaella Doro

  2. Azienda Ospedaliero Universitaria Careggi, Radiotherapy Unit, Florence University, Florence, Italy

    Icro Meattini, Benedetta Agresti, Gabriele Simontacchi, Fabiola Paiar, Monica Mangoni, Daniela Greto, Livia Marrazzo & Giampaolo Biti

Authors
  1. Pierluigi Bonomo
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  2. Lorenzo Livi
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  3. Andrea Rampini
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  4. Icro Meattini
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  5. Benedetta Agresti
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  6. Gabriele Simontacchi
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  7. Fabiola Paiar
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  8. Monica Mangoni
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  9. Ivano Bonucci
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  10. Daniela Greto
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  11. Laura Masi
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  12. Raffaella Doro
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  13. Livia Marrazzo
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  14. Giampaolo Biti
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Correspondence to Pierluigi Bonomo.

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Bonomo, P., Livi, L., Rampini, A. et al. Stereotactic body radiotherapy for cardiac and paracardiac metastases: University of Florence experience. Radiol med 118, 1055–1065 (2013). https://doi.org/10.1007/s11547-013-0932-0

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  • DOI: https://doi.org/10.1007/s11547-013-0932-0

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