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Volumetric modulated arc therapy with flattening filter free (FFF) beams for stereotactic body radiation therapy (SBRT) in patients with medically inoperable early stage non small cell lung cancer (NSCLC)

Abstract

Purpose: To assess the impact of volumetric modulated arc therapy (VMAT) with flattening filter free (FFF) beams for stereotactic body radiotherapy (SBRT) in inoperable stage I NSCLC. Current data were compared against a cohort of patients previously treated with advanced conformal techniques (3DCRT) based on conformal arcs. Methods and materials: From July 2006 to December 2011 132 patients underwent SBRT, 86 by 3DCRT with flattened beams (FF), while the last 46 with VMAT RapidArc and unflattened beams (FFF). All patients were treated with 48 Gy in four fractions of 12 Gy each. Patients underwent follow-up. Clinical outcome was evaluated with thoracic and abdominal CT scan and 18FDG-CTPET before and after treatment. Results: Both techniques achieved adequate dose conformity to the target but with a statistically significant reduction of ipsilateral lung doses in RapidArc plans and also of Beam-on-Time (BOT) with FFF mode. The median follow up was 16 months (range 2–24 months). At 1 year, local control rate was 100% with FFF beams compared with 92.5% with FF beams (p = 0.03). Conclusions: SBRT with FFF beams permitted us a safe delivery of high dose per fraction in a short treatment time and resulted in an earlier radiological response compared  More>>
Authors:
Navarria, Pierina; [1]  Ascolese, Anna Maria; Mancosu, Pietro; Alongi, Filippo; Clerici, Elena; Tozzi, Angelo; Iftode, Cristina; Reggiori, Giacomo; Tomatis, Stefano; [1]  Infante, Maurizio; Alloisio, Marco; Testori, Alberto; [2]  Fogliata, Antonella; Cozzi, Luca; [3]  Morenghi, Emanuela; Scorsetti, Marta [1] 
  1. Radiotherapy and Radiosurgery Department, Humanitas Cancer Center, Istituto Clinico Humanitas, Milan (Italy)
  2. Department of Thoracic Surgery, Humanitas Cancer Center, Istituto Clinico Humanitas, Milan (Italy)
  3. Oncology Institute of Southern Switzerland, IOSI, Bellinzona (Switzerland)
Publication Date:
Jun 15, 2013
Product Type:
Journal Article
Resource Relation:
Journal Name: Radiotherapy and Oncology; Journal Volume: 107; Journal Issue: 3; Other Information: Copyright (c) 2013 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; COMPARATIVE EVALUATIONS; LUNGS; NEOPLASMS; RADIATION DOSES; RADIOTHERAPY
OSTI ID:
22267015
Country of Origin:
Ireland
Language:
English
Other Identifying Numbers:
Journal ID: ISSN 0167-8140; CODEN: RAONDT; Other: PII: S0167-8140(13)00191-6; TRN: IE14R0108088246
Availability:
Available from http://dx.doi.org/10.1016/j.radonc.2013.04.016
Submitting Site:
INIS
Size:
page(s) 414-418
Announcement Date:
Oct 06, 2014

Citation Formats

Navarria, Pierina, Ascolese, Anna Maria, Mancosu, Pietro, Alongi, Filippo, Clerici, Elena, Tozzi, Angelo, Iftode, Cristina, Reggiori, Giacomo, Tomatis, Stefano, Infante, Maurizio, Alloisio, Marco, Testori, Alberto, Fogliata, Antonella, Cozzi, Luca, Morenghi, Emanuela, and Scorsetti, Marta. Volumetric modulated arc therapy with flattening filter free (FFF) beams for stereotactic body radiation therapy (SBRT) in patients with medically inoperable early stage non small cell lung cancer (NSCLC). Ireland: N. p., 2013. Web. doi:10.1016/J.RADONC.2013.04.016.
Navarria, Pierina, Ascolese, Anna Maria, Mancosu, Pietro, Alongi, Filippo, Clerici, Elena, Tozzi, Angelo, Iftode, Cristina, Reggiori, Giacomo, Tomatis, Stefano, Infante, Maurizio, Alloisio, Marco, Testori, Alberto, Fogliata, Antonella, Cozzi, Luca, Morenghi, Emanuela, & Scorsetti, Marta. Volumetric modulated arc therapy with flattening filter free (FFF) beams for stereotactic body radiation therapy (SBRT) in patients with medically inoperable early stage non small cell lung cancer (NSCLC). Ireland. https://doi.org/10.1016/J.RADONC.2013.04.016
Navarria, Pierina, Ascolese, Anna Maria, Mancosu, Pietro, Alongi, Filippo, Clerici, Elena, Tozzi, Angelo, Iftode, Cristina, Reggiori, Giacomo, Tomatis, Stefano, Infante, Maurizio, Alloisio, Marco, Testori, Alberto, Fogliata, Antonella, Cozzi, Luca, Morenghi, Emanuela, and Scorsetti, Marta. 2013. "Volumetric modulated arc therapy with flattening filter free (FFF) beams for stereotactic body radiation therapy (SBRT) in patients with medically inoperable early stage non small cell lung cancer (NSCLC)." Ireland. https://doi.org/10.1016/J.RADONC.2013.04.016.
@misc{etde_22267015,
title = {Volumetric modulated arc therapy with flattening filter free (FFF) beams for stereotactic body radiation therapy (SBRT) in patients with medically inoperable early stage non small cell lung cancer (NSCLC)}
author = {Navarria, Pierina, Ascolese, Anna Maria, Mancosu, Pietro, Alongi, Filippo, Clerici, Elena, Tozzi, Angelo, Iftode, Cristina, Reggiori, Giacomo, Tomatis, Stefano, Infante, Maurizio, Alloisio, Marco, Testori, Alberto, Fogliata, Antonella, Cozzi, Luca, Morenghi, Emanuela, and Scorsetti, Marta}
abstractNote = {Purpose: To assess the impact of volumetric modulated arc therapy (VMAT) with flattening filter free (FFF) beams for stereotactic body radiotherapy (SBRT) in inoperable stage I NSCLC. Current data were compared against a cohort of patients previously treated with advanced conformal techniques (3DCRT) based on conformal arcs. Methods and materials: From July 2006 to December 2011 132 patients underwent SBRT, 86 by 3DCRT with flattened beams (FF), while the last 46 with VMAT RapidArc and unflattened beams (FFF). All patients were treated with 48 Gy in four fractions of 12 Gy each. Patients underwent follow-up. Clinical outcome was evaluated with thoracic and abdominal CT scan and 18FDG-CTPET before and after treatment. Results: Both techniques achieved adequate dose conformity to the target but with a statistically significant reduction of ipsilateral lung doses in RapidArc plans and also of Beam-on-Time (BOT) with FFF mode. The median follow up was 16 months (range 2–24 months). At 1 year, local control rate was 100% with FFF beams compared with 92.5% with FF beams (p = 0.03). Conclusions: SBRT with FFF beams permitted us a safe delivery of high dose per fraction in a short treatment time and resulted in an earlier radiological response compared with FF beams.}
doi = {10.1016/J.RADONC.2013.04.016}
journal = []
issue = {3}
volume = {107}
journal type = {AC}
place = {Ireland}
year = {2013}
month = {Jun}
}