title: Safety and efficacy of intensity-modulated stereotactic body radiotherapy using helical tomotherapy for lung cancer and lung metastasis.
abstract: Stereotactic body radiotherapy (SBRT) proved to be an effective treatment with acceptable toxicity for lung tumors. However, the use of helical intensity-modulated (IM) SBRT is controversial. We investigated the outcome of lung tumor patients treated by IMSBRT using helical tomotherapy with a Japanese standard fractionation schedule of 48 Gy in 4 fractions (n = 37) or modified protocols of 50-60 Gy in 5-8 fractions (n = 35). Median patient's age was 76 years and median follow-up period for living patients was 20 months (range, 6-46). The median PTV was 6.9 cc in the 4-fraction group and 14 cc in the 5- to 8-fraction group (P = 0.001). Grade 2 radiation pneumonitis was seen in 2 of 37 patients in the 4-fraction group and in 2 of 35 patients in the 5- to 8-fraction group (log-rank P = 0.92). Other major complications were not observed. The LC rates at 2 years were 87% in the 4-fraction group and 83% in the 5- to 8-fraction group. Helical IMSBRT for lung tumors is safe and effective. Patients with a high risk of developing severe complications may also be safely treated using 5-8 fractions. The results of the current study warrant further studies of helical IMSBRT.
authors.affiliation: Radiation Therapy Center, Fukui Saiseikai Hospital, 7-1 Funabashi, Wadanaka-cho, Fukui 918-8503, Japan ; Department of Radiology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan.
authors.forename: Aiko
authors.identifier: 0000-0001-9544-6870
authors.initials: A
authors.lastname: Nagai
authors.affiliation: Department of Radiology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan.
authors.forename: Yuta
authors.identifier: 0000-0003-4255-8611
authors.initials: Y
authors.lastname: Shibamoto
authors.affiliation: Radiation Therapy Center, Fukui Saiseikai Hospital, 7-1 Funabashi, Wadanaka-cho, Fukui 918-8503, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Yoshida
authors.affiliation: Department of Radiological Technology, Fukui Saiseikai Hospital, 7-1 Funabashi, Wadanaka-cho, Fukui 918-8503, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Inoda
authors.affiliation: Radiation Therapy Center, Fukui Saiseikai Hospital, 7-1 Funabashi, Wadanaka-cho, Fukui 918-8503, Japan.
authors.forename: Yuzo
authors.initials: Y
authors.lastname: Kikuchi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000473:pathology / Q000532:radiotherapy*; D016634:Radiosurgery; D050397:Radiotherapy, Intensity-Modulated