title: Early pulmonary toxicity following lung stereotactic body radiation therapy delivered in consecutive daily fractions.
abstract: OBJECTIVE
  Identify the incidence of early pulmonary toxicity in a cohort of patients treated with lung stereotactic body radiation therapy (SBRT) on consecutive treatment days.
  
  
  METHODS
  A total of 88 lesions in 84 patients were treated with SBRT in consecutive daily fractions (Fx) for medically inoperable non-small cell lung cancer or metastasis. The incidence of pneumonitis was evaluated and graded according to the NCI CTCAE v3.0.
  
  
  RESULTS
  With a median follow-up of 15.8 months (range 2.5-28.6), the median age at SBRT was 71.8 years (range 23.8-87.8). 47 lesions were centrally located and 41 were peripheral. Most central lesions were treated with 48Gy in 4 Fx, and most peripheral lesions with 54Gy in 3 Fx. The incidence of grade ≥ 2 pneumonitis was 12.5% in all patients treated, and 14.3% among the subset of patients treated with 54Gy in 3 Fx. A total of two grade 3 toxicities were seen as one grade 5 toxicity in a patient treated for recurrence after pneumonectomy.
  
  
  CONCLUSIONS
  Treating both central and peripheral lung lesions with SBRT in consecutive daily fractions in this cohort was well tolerated and did not cause excessive early pulmonary toxicity.
authors.affiliation: Department of Radiation Oncology, Mayo Clinic, Rochester, USA. stauder.michael@mayo.edu
authors.forename: Michael C
authors.initials: MC
authors.lastname: Stauder
authors.forename: O Kenneth
authors.initials: OK
authors.lastname: Macdonald
authors.forename: Kenneth R
authors.initials: KR
authors.lastname: Olivier
authors.forename: Jason A
authors.initials: JA
authors.lastname: Call
authors.forename: Kyle
authors.initials: K
authors.lastname: Lafata
authors.forename: Charles S
authors.initials: CS
authors.lastname: Mayo
authors.forename: Robert C
authors.initials: RC
authors.lastname: Miller
authors.forename: Paul D
authors.initials: PD
authors.lastname: Brown
authors.forename: Heather J
authors.initials: HJ
authors.lastname: Bauer
authors.forename: Yolanda I
authors.initials: YI
authors.lastname: Garces
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D054893:Cone-Beam Computed Tomography; D019583:Dose Fractionation, Radiation; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011013:Pneumonectomy; D016016:Proportional Hazards Models; D011446:Prospective Studies; D017564:Radiation Pneumonitis / Q000453:epidemiology*; D016634:Radiosurgery / Q000379:methods*; D012042:Registries; D015996:Survival Rate; D016896:Treatment Outcome