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Safety of high-dose-rate stereotactic body radiotherapy


Stieb, Sonja; Lang, Stephanie; Linsenmeier, Claudia; Graydon, Shaun; Riesterer, Oliver (2015). Safety of high-dose-rate stereotactic body radiotherapy. Radiation Oncology, 10(27):online.

Abstract

Background and purposeFlattening filter free (FFF) beams with high dose rate are increasingly used for stereotactic body radiotherapy (SBRT), because they substantially shorten beam-on time. The physical properties of these beams together with potentially unknown radiobiological effects might affect patient safety. Therefore here we analyzed the clinical outcome of our patients.Material and methodsBetween 3/2010 and 2/2014 84 patients with 100 lesions (lung 75, liver 10, adrenal 6, lymph nodes 5, others 4) were treated with SBRT using 6 MV FFF or 10 MV FFF beams at our institution. Clinical efficacy endpoints and toxicity were assessed by Kaplan-Meier analysis and CTCAE criteria version 4.0.ResultsMedian follow-up was 11 months (range: 3¿41). No severe acute toxicity was observed. There has been one case of severe late toxicity (1%), a grade 3 bile duct stricture that was possibly related to SBRT. For all patients, the 1-year local control rate, progression free survival and overall survival were 94%, 38% and 80% respectively, and for patients with lung lesions 94%, 48% and 83%, respectively.ConclusionsNo unexpected toxicity occurred. Toxicity and treatment efficacy are perfectly in range with studies investigating SBRT with flattened beams. The use of FFF beams at maximum dose rate for SBRT is time efficient and appears to be safe.

Abstract

Background and purposeFlattening filter free (FFF) beams with high dose rate are increasingly used for stereotactic body radiotherapy (SBRT), because they substantially shorten beam-on time. The physical properties of these beams together with potentially unknown radiobiological effects might affect patient safety. Therefore here we analyzed the clinical outcome of our patients.Material and methodsBetween 3/2010 and 2/2014 84 patients with 100 lesions (lung 75, liver 10, adrenal 6, lymph nodes 5, others 4) were treated with SBRT using 6 MV FFF or 10 MV FFF beams at our institution. Clinical efficacy endpoints and toxicity were assessed by Kaplan-Meier analysis and CTCAE criteria version 4.0.ResultsMedian follow-up was 11 months (range: 3¿41). No severe acute toxicity was observed. There has been one case of severe late toxicity (1%), a grade 3 bile duct stricture that was possibly related to SBRT. For all patients, the 1-year local control rate, progression free survival and overall survival were 94%, 38% and 80% respectively, and for patients with lung lesions 94%, 48% and 83%, respectively.ConclusionsNo unexpected toxicity occurred. Toxicity and treatment efficacy are perfectly in range with studies investigating SBRT with flattened beams. The use of FFF beams at maximum dose rate for SBRT is time efficient and appears to be safe.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Radiation Oncology
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:23 January 2015
Deposited On:22 Apr 2015 14:54
Last Modified:08 Dec 2017 12:49
Publisher:BioMed Central
ISSN:1748-717X
Free access at:PubMed ID. An embargo period may apply.
Publisher DOI:https://doi.org/10.1186/s13014-014-0317-0
PubMed ID:25614416

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