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Stereotactic body radiotherapy using gated radiotherapy with real-time tumor-tracking for stage I non-small cell lung cancer

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Title: Stereotactic body radiotherapy using gated radiotherapy with real-time tumor-tracking for stage I non-small cell lung cancer
Authors: Inoue, Tetsuya Browse this author →KAKEN DB
Katoh, Norio Browse this author →KAKEN DB
Onimaru, Rikiya Browse this author →KAKEN DB
Shimizu, Shinichi Browse this author →KAKEN DB
Tsuchiya, Kazuhiko Browse this author →KAKEN DB
Suzuki, Ryusuke Browse this author →KAKEN DB
Sakakibara-Konishi, Jun Browse this author →KAKEN DB
Shinagawa, Naofumi Browse this author →KAKEN DB
Oizumi, Satoshi Browse this author →KAKEN DB
Shirato, Hiroki Browse this author →KAKEN DB
Keywords: Stereotactic body radiotherapy
Radiation pneumonitis
Non-small cell lung cancer
Real-time tumor-tracking
Tumor motion
Gated radiotherapy
Issue Date: 21-Mar-2013
Journal Title: Radiation Oncology
Volume: 8
Start Page: 69
Publisher DOI: 10.1186/1748-717X-8-69
Abstract: Background: To clarify the clinical outcomes of two dose schedule of stereotactic body radiotherapy (SBRT) for stage I non-small cell lung cancer (NSCLC) using a real-time tumor-tracking radiation therapy (RTRT) system in single institution. Methods: Using a superposition algorithm, we administered 48 Gy in 4 fractions at the isocenter in 2005-2006 and 40 Gy in 4 fractions to the 95% volume of PTV in 2007-2010 with a treatment period of 4 to 7 days. Target volume margins were fixed irrespective of the tumor amplitude. Results: In total, 109 patients (79 T1N0M0 and 30 T2N0M0). With a median follow-up period of 25 months (range, 4 to 72 months), the 5-year local control rate (LC) was 78% and the 5-year overall survival rate (OS) was 64%. Grade 2, 3, 4, and 5 radiation pneumonitis (RP) was experienced by 15 (13.8%), 3 (2.8%), 0, and 0 patients, respectively. The mean lung dose (MLD) and the volume of lung receiving 20 Gy (V20) were significantly higher in patients with RP Grade 2/3 than in those with RP Grade 0/1 (MLD p = 0.002, V20 p = 0.003). There was no correlation between larger maximum amplitude of marker movement and larger PTV (r = 0.137), MLD (r = 0.046), or V20 (r = 0.158). Conclusions: SBRT using the RTRT system achieved LC and OS comparable to other SBRT studies with very low incidence of RP, which was consistent with the small MLD and V20 irrespective of tumor amplitude. For stage I NSCLC, SBRT using RTRT was suggested to be reliable and effective, especially for patients with large amplitude of tumor movement.
Type: article
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 井上 哲也

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