Safety and Efficacy of Intensity-Modulated Stereotactic Body Radiotherapy Using Helical Tomotherapy for Lung Cancer and Lung Metastasis

• Main Authors: Aiko Nagai, Yuta Shibamoto, Masanori Yoshida, Koji Inoda, Yuzo Kikuchi
• Format: Article
• Language: English
• Published: Hindawi Limited 2014-01-01
• Series: BioMed Research International
• Online Access: http://dx.doi.org/10.1155/2014/473173

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.