PURPOSE: To evaluate the treatment-induced toxicity (as primary endpoint) and the efficacy (as secondary endpoint) of stereotactic body radiation therapy (SBRT) in the treatment of mediastinal lymph nodes (LNs) in the so-called no-fly zone (NFZ) in cancers with various histology. MATERIAL AND METHODS: Forty-two patients were retrospectively analyzed. Institutional dose/volume constraints for organs at risk (OARs) derived by published data were strictly respected. The correlation between treatment-related variables and toxicity was investigated by logistic regression, Chi-squared test or Fisher's exact test. Overall survival (OS), cause-specific survival (CSS), progression-free survival (PFS) and local control (LC) were collected from the follow-up reports. The impact of potential predictive factors on LC, PFS and OS were estimated by Cox proportional-hazard regression. RESULTS: Median follow-up time was 16 months (range 1-41). Four patients had esophageal G1 toxicity. Ten and six patients had G1 and G2 pulmonary toxicity, respectively. Treatment site and irradiation technique were significantly correlated with G ≥ 2 and G ≥ 1 toxicity, respectively. OS probability at 19 months was 88.3% and corresponded to CSS. LC probability at 16 months was 66.3% (median LC duration: 22 months, range 1-41). Fifteen patients (35.7%) were disease-free at 25 months (median time, range 1-41). The biologically effective dose (BED) and the target dose coverage indexes were significantly correlated with LC. CONCLUSIONS: SBRT can be considered as a safe treatment option for selected patients with oligo-metastases/recurrences in the NFZ, if strict dose/volume constraints are applied.
Stereotactic body radiation therapy for mediastinal lymph node metastases : how do we fly in a 'no-fly zone'? / B.A. Jereczek-Fossa, M. Muto, S. Durante, A. Ferrari, G. Piperno, C. Fodor, S. Comi, R. Ricotti, C. Garibaldi, S. Dicuonzo, S. Mazza, F. Golino, L. Spaggiari, F. De Marinis, R. Orecchia, D. Ciardo, P. Fossati. - In: ACTA ONCOLOGICA. - ISSN 1651-226X. - 57:11(2018 Nov), pp. 1532-1539.
|Titolo:||Stereotactic body radiation therapy for mediastinal lymph node metastases : how do we fly in a 'no-fly zone'?|
JERECZEK, BARBARA ALICJA (Primo)
DURANTE, STEFANO (Corresponding)
|Settore Scientifico Disciplinare:||Settore MED/36 - Diagnostica per Immagini e Radioterapia|
|Data di pubblicazione:||nov-2018|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1080/0284186X.2018.1486040|
|Appare nelle tipologie:||01 - Articolo su periodico|