title: Establishing stereotactic body radiotherapy with flattening filter free techniques in the treatment of pulmonary lesions - initial experiences from a single institution
creator: Rieber, Juliane
creator: Tonndorf-Martini, Eric
creator: Schramm, Oliver
creator: Rhein, Bernhard
creator: König, Laila
creator: Adeberg, Sebastian
creator: Meyerhof, Eva
creator: Mohr, Angela
creator: Kappes, Jutta
creator: Hoffmann, Hans
creator: Debus, Jürgen
creator: Rieken, Stefan
subject: 610
subject: 610 Medical sciences Medicine
description: Background: Stereotactic body radiotherapy (SBRT) using flattening filter free (FFF)-techniques has been increasingly applied during the last years. However, clinical studies investigating this emerging technique are still rare. Hence, we analyzed toxicity and clinical outcome of pulmonary SBRT with FFF-techniques and performed dosimetric comparison to conventional techniques using flattening filters (FF).   Materials and methods: Between 05/2014 and 06/2015, 56 consecutive patients with 61 pulmonary lesions were treated with SBRT in FFF-mode. Central lesions received 8 × 7.5 Gy delivered to the conformally enclosing 80%-isodose, while peripheral lesions were treated with 3 × 15 Gy, prescribed to the 65%-isodose. Early and late toxicity (after 6 months) as well as initial clinical outcomes were evaluated. Furthermore, [deleted] plan quality and efficiency were evaluated by analyzing conformity, beam- on and total treatment delivery times in comparison to plans with FF-dose application.   Results: Median follow-up time was 9.3 months (range 1.5–18.0 months). Early toxicity was low with only 5 patients (8.9 %) reporting CTCAE 2° or higher side-effects. Only one patient (1.8 %) was diagnosed with radiation-induced pneumonitis CTCAE 3°, while 2 (3.6 %) patients suffered from pneumonitis CTCAE 2°. After 6 months, no toxicity greater than CTCAE 2° was reported. 1-year local progression-free survival, distant progression-free survival and overall survival were 92.8 %, 78.0 %, and 94.4 %, respectively. While plan quality was similar for FFF- and FF-plans in respect to conformity (p = 0.275), median beam-on time as well as total treatment time were significantly reduced for SBRT in FFF-mode compared to FF-mode (p ≤ 0.001, p ≤ 0.001).   Conclusions: Patient treatment with SBRT using FFF-techniques is safe and provides promising clinical results with only modest toxicity at significantly increased dose delivery speed.
publisher: BioMed Central
date: 2016
type: Article
type: info:eu-repo/semantics/article
type: NonPeerReviewed
format: application/pdf
identifier: https://archiv.ub.uni-heidelberg.de/volltextserverhttps://archiv.ub.uni-heidelberg.de/volltextserver/21524/1/13014_2016_Article_648.pdf
identifier: DOI:
identifier: urn:nbn:de:bsz:16-heidok-215244
identifier:   Rieber, Juliane ; Tonndorf-Martini, Eric ; Schramm, Oliver ; Rhein, Bernhard ; König, Laila ; Adeberg, Sebastian ; Meyerhof, Eva ; Mohr, Angela ; Kappes, Jutta ; Hoffmann, Hans ; Debus, Jürgen ; Rieken, Stefan  (2016) Establishing stereotactic body radiotherapy with flattening filter free techniques in the treatment of pulmonary lesions - initial experiences from a single institution.  Radiation Oncology, 11 (80).  pp. 1-8.  ISSN 1748-717X     
relation: https://archiv.ub.uni-heidelberg.de/volltextserver/21524/
rights: info:eu-repo/semantics/openAccess
rights: Please see front page of the work (Sorry, Dublin Core plugin does not recognise license id)
language: eng