eprintid: 19425 rev_number: 17 eprint_status: archive userid: 1589 dir: disk0/00/01/94/25 datestamp: 2015-12-22 09:44:02 lastmod: 2024-04-28 23:14:43 status_changed: 2015-12-22 09:44:02 type: article metadata_visibility: show creators_name: Boda-Heggemann, Judit creators_name: Frauenfeld, Anian creators_name: Weiss, Christel creators_name: Simeonova, Anna creators_name: Neumaier, Christian creators_name: Siebenlist, Kerstin creators_name: Attenberger, Ulrike creators_name: Heußel, Claus Peter creators_name: Schneider, Frank creators_name: Wenz, Frederik creators_name: Lohr, Frank title: Clinical outcome of hypofractionated breath-hold image-guided SABR of primary lung tumors and lung metastases subjects: ddc-610 divisions: i-61800 divisions: i-63000 divisions: i-63500 divisions: i-950900 abstract: Background: Stereotactic Ablative RadioTherapy (SABR) of lung tumors/metastases has been shown to be an effective treatment modality with low toxicity. Outcome and toxicity were retrospectively evaluated in a unique single-institution cohort treated with intensity-modulated image-guided breath-hold SABR (igSABR) without external immobilization. The dose–response relationship is analyzed based on Biologically Equivalent Dose (BED). Patients and methods: 50 lesions in 43 patients with primary NSCLC (n = 27) or lung-metastases of various primaries (n = 16) were consecutively treated with igSABR with Active-Breathing-Coordinator (ABC®) and repeat-breath-hold cone-beam-CT. After an initial dose-finding/-escalation period, 5x12 Gy for peripheral lesions and single doses of 5 Gy to varying dose levels for central lesions were applied. Overall-survival (OS), progression-free-survival (PFS), progression pattern, local control (LC) and toxicity were analyzed. Results: The median BED2 was 83 Gy. 12 lesions were treated with a BED2 of <80 Gy, and 38 lesions with a BED2 of <80 Gy. Median follow-up was 15 months. Actuarial 1- and 2-year OS were 67% and 43%; respectively. Cause of death was non-disease-related in 27%. Actuarial 1- and 2-year PFS was 42% and 28%. Progression site was predominantly distant. Actuarial 1- and 2 year LC was 90% and 85%. LC showed a trend for a correlation to BED2 (p = 0.1167). Pneumonitis requiring conservative treatment occurred in 23%. Conclusion: Intensity-modulated breath-hold igSABR results in high LC-rates and low toxicity in this unfavorable patient cohort with inoperable lung tumors or metastases. A BED2 of <80 Gy was associated with reduced local control. date: 2014 publisher: BioMed Central id_scheme: DOI ppn_swb: 1653719397 own_urn: urn:nbn:de:bsz:16-heidok-194251 language: eng bibsort: BODAHEGGEMCLINICALOU2014 full_text_status: public publication: Radiation Oncology volume: 9 number: 10 place_of_pub: London pagerange: 1-9 issn: 1748-717X citation: Boda-Heggemann, Judit ; Frauenfeld, Anian ; Weiss, Christel ; Simeonova, Anna ; Neumaier, Christian ; Siebenlist, Kerstin ; Attenberger, Ulrike ; Heußel, Claus Peter ; Schneider, Frank ; Wenz, Frederik ; Lohr, Frank (2014) Clinical outcome of hypofractionated breath-hold image-guided SABR of primary lung tumors and lung metastases. Radiation Oncology, 9 (10). pp. 1-9. ISSN 1748-717X document_url: https://archiv.ub.uni-heidelberg.de/volltextserver/19425/1/13014_2013_Article_1211.pdf