ArticleTechnical innovations & patient support in radiation oncology2020
Stereotactic body radiotherapy for moderately central and ultra-central oligometastatic disease: Initial outcomes.
Article in Technical innovations & patient support in radiation oncology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Stereotactic body radiation therapy for ultra-central lung malignancies: an updated systematic review and meta-analysis.Radiation oncology (London, England) · 2026Pooled it
- Assessment of planning organ at risk volume margins in non-adaptive pancreatic stereotactic body radiotherapy.Physics and imaging in radiation oncology · 2026Article
- Outcome and safety of SBRT in centrally and ultra-centrally located lung tumours: A PRISMA-based systematic review and Meta-Analysis.Clinical and translational radiation oncology · 2026Article
- Recent Advances and Current Challenges in Stereotactic Body Radiotherapy for Ultra-Central Lung Tumors.Cancers · 2024Review
- Dosimetric Analysis of Proximal Bronchial Tree Subsegments to Assess The Risk of Severe Toxicity After Stereotactic Body Radiation Therapy of Ultra-central Lung Tumors.Clinical and translational radiation oncology · 2024Article
- Accelerated Hypofractionated Magnetic Resonance Guided Adaptive Radiation Therapy for Ultracentral Lung Tumors.Tomography (Ann Arbor, Mich.) · 2024Article
- Volumetric modulated arc therapy (VMAT): a review of clinical outcomes-what is the clinical evidence for the most effective implementation?The British journal of radiology · 2022Review
- Dose-response relationship of stereotactic body radiotherapy for ultracentral tumor and comparison of efficacy with central tumor: a meta-analysis.Translational lung cancer research · 2020Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundDelivery of SBRT to central thoracic tumours within 2 cm of the proximal bronchial tree (PBT), and especially ultra-central tumours which directly abut the PBT, has been controversial due to concerns about high risk of toxicity and treatment-related death when delivering high doses close to critical mediastinal structures. We present dosimetric and clinical outcomes from a group of oligometastatic patients treated with a risk-adapted SBRT approach.
methodsBetween September 2015 and October 2018, 27 patients with 28 central thoracic oligometastases (6 moderately central, 22 ultra-central) were treated with 60 Gy in 8 fractions under online CBCT guidance. PTV dose was compromised where necessary to meet mandatory OAR constraints. Patients were followed up for toxicity and disease status.
resultsMandatory OAR constraints were met in all cases; this required PTV coverage compromise in 23 cases, with V100% reduced to <70% in 11 cases. No acute or late toxicities of Grade ≥ 3 were reported. One and 2 year in-field control rates were 95.2% and 85.7% respectively, progression-free survival rates were 42.8% and 23.4% respectively, and overall survival rates were 82.7% and 69.5% respectively. No significant differences were seen in control or survival rates by extent of PTV underdosage or between moderately and ultra-central cases.
conclusionIt appears that compromising PTV coverage to meet OAR constraints allows safe and effective delivery of SBRT to moderately and ultra-central tumours, with low toxicity rates and high in-field control rates. This treatment can be delivered on standard linear accelerators with widely available imaging technology.
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