title: Stereotactic body radiotherapy for cardiac and paracardiac metastases: University of Florence experience.
abstract: OBJECTIVE
  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.
  
  
  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.
authors.affiliation: Santa Chiara Radiotherapy Unit, Florence University, Via di Barbiano 2A, 50129, Florence, Italy, p_bonomo@hotmail.com.
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Bonomo
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Livi
authors.forename: Andrea
authors.initials: A
authors.lastname: Rampini
authors.forename: Icro
authors.initials: I
authors.lastname: Meattini
authors.forename: Benedetta
authors.initials: B
authors.lastname: Agresti
authors.forename: Gabriele
authors.initials: G
authors.lastname: Simontacchi
authors.forename: Fabiola
authors.initials: F
authors.lastname: Paiar
authors.forename: Monica
authors.initials: M
authors.lastname: Mangoni
authors.forename: Ivano
authors.initials: I
authors.lastname: Bonucci
authors.forename: Daniela
authors.initials: D
authors.lastname: Greto
authors.forename: Laura
authors.initials: L
authors.lastname: Masi
authors.forename: Raffaella
authors.initials: R
authors.lastname: Doro
authors.forename: Livia
authors.initials: L
authors.lastname: Marrazzo
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Biti
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D005260:Female; D006338:Heart Neoplasms / Q000556:secondary* / Q000601:surgery*; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D016634:Radiosurgery / Q000379:methods*; D011879:Radiotherapy Dosage; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome