Page 71 - Fisica In Medicina n° 1/2017

Materials and MethodsFrom 2010 to 2015, 45 central lesions in 40 pts were treated with SBRT. 14 lesions were primary lung cancer (PLC), 31 were lymphoadenopathies (LAP). PLC were treated with volumetric arc Therapy (VMAT) in 9 cases and 5 with Cyberknife®. LAP were treated with VMAT in 12 cases, with IMRT (step and shoot) in 10 and with Cyberknife® in 9 cases. Prescribed doses varied between 26 and 60 Gy (1-8 fractions) with median BED of 69 Gy (37,5-105 Gy).We evaluated Overall Survival (OS), Progression Free Survival (PFS) and Disease Specific Survival (DSS) using Kaplan-Meier method and treatment related toxicities using CTCAE version 4.0.ResultsMedian age was 62 years (48-86), 26 male and 14 female. PS was 0 in 9 pts, 1 in 21, 2 in 10 pts. Histology was available in all series and consisted of primary NSCLC (32 adenocarcinoma, 12 squamous cell carcinomas, 1 neuroendocrine tumour). 41 PLC were less than 2 cm from proximal bronchial tree, 4 PLC were immediately adjacent to the mediastinal or pericardial pleura. Tumor diameter was 10 to 60 mm with a median of 31 mm.Median follow up was 14,5 months.OS and DSS were 86.5% at 1 year, 55.6% at 2 years, and 49,4% at 3 years. PFS was 48,6% at 1 year, 24,1% at 2 years, and 12% at 3 years.23 patients had clinical benefit from treatment (4 complete response, 15 partial response, 4 stable disease).35 pts showed no acute toxicity; in 5 pts we recorded grade 1-2 esophagitis, in 2 pts grade 2 cough, in 2 pts, grade 1 asthenia.Chronic toxicity was present in 2 pts as grade 2 esophagitis.ConclusionSBRT is confirmed to be a safe and effective strategy for central lung tumors. Despite the majority of patients in the first part of our series was treated with different fractionations and with different prescription isodoses compared to current doses, 57% of patients had clinical benefit from the treatment without life-threatening toxicities.Further studies are needed to establish the efficacy and safety of SBRT in central lung lesions.^Äëíê~Åí=jÉÇáÅá= =62