title: Feasibility and early clinical assessment of flattening filter free (FFF) based stereotactic body radiotherapy (SBRT) treatments.
abstract: OBJECTIVE
  To test feasibility and safety of clinical usage of Flattening Filter Free (FFF) beams for delivering ablative stereotactic body radiation therapy (SBRT) doses to various tumor sites, by means of Varian TrueBeam™ (Varian Medical Systems).
  
  
  METHODS
  Seventy patients were treated with SBRT and FFF: 51 lesions were in the thorax (48 patients),10 in the liver, 9 in isolated abdominal lymph node, adrenal gland or pancreas. Doses ranged from 32 to 75 Gy, depending on the anatomical site and the volume of the lesion to irradiate. Lung lesions were treated with cumulative doses of 32 or 48 Gy, delivered in 4 consecutive fractions. The liver patients were treated in 3 fractions with total dose of 75 Gy. The isolated lymph nodes were irradiated in 6 fractions with doses of 45 Gy. The inclusion criteria were the presence of isolated node, or few lymph nodes in the same lymph node region, in absence of other active sites of cancer disease before the SBRT treatment.
  
  
  RESULTS
  All 70 patients completed the treatment. The minimum follow-up was 3 months. Six cases of acute toxicities were recorded (2 Grade2 and 2 Grade3 in lung and 2 Grade2 in abdomen). No patient experienced acute toxicity greater than Grade3. No other types or grades of toxicities were observed at clinical evaluation visits.
  
  
  CONCLUSIONS
  This study showed that, with respect to acute toxicity, SBRT with FFF beams showed to be a feasible technique in 70 consecutive patients with various primary and metastatic lesions in the body.
authors.affiliation: Radiotherapy and Radiosurgery, Humanitas Cancer Center, Istituto Clinico Humanitas, Rozzano (Milano), Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Scorsetti
authors.forename: Filippo
authors.initials: F
authors.lastname: Alongi
authors.forename: Simona
authors.initials: S
authors.lastname: Castiglioni
authors.forename: Alessandro
authors.initials: A
authors.lastname: Clivio
authors.forename: Antonella
authors.initials: A
authors.lastname: Fogliata
authors.forename: Francesca
authors.initials: F
authors.lastname: Lobefalo
authors.forename: Pietro
authors.initials: P
authors.lastname: Mancosu
authors.forename: Pierina
authors.initials: P
authors.lastname: Navarria
authors.forename: Valentina
authors.initials: V
authors.lastname: Palumbo
authors.forename: Chiara
authors.initials: C
authors.lastname: Pellegrini
authors.forename: Sara
authors.initials: S
authors.lastname: Pentimalli
authors.forename: Giacomo
authors.initials: G
authors.lastname: Reggiori
authors.forename: Anna M
authors.initials: AM
authors.lastname: Ascolese
authors.forename: Antonella
authors.initials: A
authors.lastname: Roggio
authors.forename: Stefano
authors.initials: S
authors.lastname: Arcangeli
authors.forename: Angelo
authors.initials: A
authors.lastname: Tozzi
authors.forename: Eugenio
authors.initials: E
authors.lastname: Vanetti
authors.forename: Luca
authors.initials: L
authors.lastname: Cozzi
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000532:radiotherapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004307:Dose-Response Relationship, Radiation; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000532:radiotherapy; D008207:Lymphatic Metastasis / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000532:radiotherapy*; D010190:Pancreatic Neoplasms / Q000532:radiotherapy; D011874:Radiometry / Q000379:methods; D016634:Radiosurgery / Q000379:methods*; D013899:Thoracic Neoplasms / Q000532:radiotherapy; D016896:Treatment Outcome