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Title: Predictors of Local Control After Single-Dose Stereotactic Image-Guided Intensity-Modulated Radiotherapy for Extracranial Metastases

Abstract

Purpose: To report tumor local control after treatment with single-dose image-guided intensity-modulated radiotherapy (SD-IGRT) to extracranial metastatic sites. Methods and Materials: A total of 126 metastases in 103 patients were treated with SD-IGRT to prescription doses of 18-24 Gy (median, 24 Gy) between 2004 and 2007. Results: The overall actuarial local relapse-free survival (LRFS) rate was 64% at a median follow-up of 18 months (range, 2-45 months). The median time to failure was 9.6 months (range, 1-23 months). On univariate analysis, LRFS was significantly correlated with prescription dose (p = 0.029). Stratification by dose into high (23 to 24 Gy), intermediate (21 to 22 Gy), and low (18 to 20 Gy) dose levels revealed highly significant differences in LRFS between high (82%) and low doses (25%) (p < 0.0001). Overall, histology had no significant effect on LRFS (p = 0.16). Renal cell histology displayed a profound dose-response effect, with 80% LRFS at the high dose level (23 to 24 Gy) vs. 37% with low doses ({<=}22 Gy) (p = 0.04). However, for patients who received the high dose level, histology was not a statistically significant predictor of LRFS (p = 0.90). Target organ (bone vs. lymph node vs. soft tissues)more » (p = 0.5) and planning target volume size (p = 0.55) were not found to be associated with long-term LRFS probability. Multivariate Cox regression analysis confirmed prescription dose to be a significant predictor of LRFS (p = 0.003). Conclusion: High-dose SD-IGRT is a noninvasive procedure resulting in high probability of local tumor control. Single-dose IGRT may be effectively used to locally control metastatic deposits regardless of histology and target organ, provided sufficiently high doses (> 22 Gy) of radiation are delivered.« less

Authors:
 [1];  [2];  [1];  [2]; ; ; ;  [1]
  1. Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)
  2. Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)
Publication Date:
OSTI Identifier:
21491671
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 79; Journal Issue: 4; Other Information: DOI: 10.1016/j.ijrobp.2009.12.038; PII: S0360-3016(09)03704-3; Copyright (c) 2011 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; METASTASES; NEOPLASMS; RADIATION DOSES; RADIOTHERAPY; SKULL; BODY; DISEASES; DOSES; MEDICINE; NUCLEAR MEDICINE; ORGANS; RADIOLOGY; SKELETON; THERAPY

Citation Formats

Greco, Carlo, Zelefsky, Michael J., E-mail: zelefskm@mskcc.or, Lovelock, Michael, Fuks, Zvi, Hunt, Margie, Rosenzweig, Kenneth, Zatcky, Joan, Kim, Balem, and Yamada, Yoshiya. Predictors of Local Control After Single-Dose Stereotactic Image-Guided Intensity-Modulated Radiotherapy for Extracranial Metastases. United States: N. p., 2011. Web. doi:10.1016/j.ijrobp.2009.12.038.
Greco, Carlo, Zelefsky, Michael J., E-mail: zelefskm@mskcc.or, Lovelock, Michael, Fuks, Zvi, Hunt, Margie, Rosenzweig, Kenneth, Zatcky, Joan, Kim, Balem, & Yamada, Yoshiya. Predictors of Local Control After Single-Dose Stereotactic Image-Guided Intensity-Modulated Radiotherapy for Extracranial Metastases. United States. https://doi.org/10.1016/j.ijrobp.2009.12.038
Greco, Carlo, Zelefsky, Michael J., E-mail: zelefskm@mskcc.or, Lovelock, Michael, Fuks, Zvi, Hunt, Margie, Rosenzweig, Kenneth, Zatcky, Joan, Kim, Balem, and Yamada, Yoshiya. 2011. "Predictors of Local Control After Single-Dose Stereotactic Image-Guided Intensity-Modulated Radiotherapy for Extracranial Metastases". United States. https://doi.org/10.1016/j.ijrobp.2009.12.038.
@article{osti_21491671,
title = {Predictors of Local Control After Single-Dose Stereotactic Image-Guided Intensity-Modulated Radiotherapy for Extracranial Metastases},
author = {Greco, Carlo and Zelefsky, Michael J., E-mail: zelefskm@mskcc.or and Lovelock, Michael and Fuks, Zvi and Hunt, Margie and Rosenzweig, Kenneth and Zatcky, Joan and Kim, Balem and Yamada, Yoshiya},
abstractNote = {Purpose: To report tumor local control after treatment with single-dose image-guided intensity-modulated radiotherapy (SD-IGRT) to extracranial metastatic sites. Methods and Materials: A total of 126 metastases in 103 patients were treated with SD-IGRT to prescription doses of 18-24 Gy (median, 24 Gy) between 2004 and 2007. Results: The overall actuarial local relapse-free survival (LRFS) rate was 64% at a median follow-up of 18 months (range, 2-45 months). The median time to failure was 9.6 months (range, 1-23 months). On univariate analysis, LRFS was significantly correlated with prescription dose (p = 0.029). Stratification by dose into high (23 to 24 Gy), intermediate (21 to 22 Gy), and low (18 to 20 Gy) dose levels revealed highly significant differences in LRFS between high (82%) and low doses (25%) (p < 0.0001). Overall, histology had no significant effect on LRFS (p = 0.16). Renal cell histology displayed a profound dose-response effect, with 80% LRFS at the high dose level (23 to 24 Gy) vs. 37% with low doses ({<=}22 Gy) (p = 0.04). However, for patients who received the high dose level, histology was not a statistically significant predictor of LRFS (p = 0.90). Target organ (bone vs. lymph node vs. soft tissues) (p = 0.5) and planning target volume size (p = 0.55) were not found to be associated with long-term LRFS probability. Multivariate Cox regression analysis confirmed prescription dose to be a significant predictor of LRFS (p = 0.003). Conclusion: High-dose SD-IGRT is a noninvasive procedure resulting in high probability of local tumor control. Single-dose IGRT may be effectively used to locally control metastatic deposits regardless of histology and target organ, provided sufficiently high doses (> 22 Gy) of radiation are delivered.},
doi = {10.1016/j.ijrobp.2009.12.038},
url = {https://www.osti.gov/biblio/21491671}, journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 4,
volume = 79,
place = {United States},
year = {Tue Mar 15 00:00:00 EDT 2011},
month = {Tue Mar 15 00:00:00 EDT 2011}
}