Stereotactic Body Frame Based Fractionated Radiosurgery for Primary or Metastatic Thoracic Tumors Sang Min Yoon, Eun Kyung Choi, Sang-wook Lee, Byong Yong.

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Presentation transcript:

Stereotactic Body Frame Based Fractionated Radiosurgery for Primary or Metastatic Thoracic Tumors Sang Min Yoon, Eun Kyung Choi, Sang-wook Lee, Byong Yong Yi, Jong Hoon Kim, Seung Do Ahn, Seong Soo Shin, Su Ssan Kim, Si Yeol Song Dept. of Radiation Oncology, Asan Medical Center, University of Ulsan, Seoul, Korea;

Stereotactic Body Frame (Elekta) Vacuum Mold Leg Laser Abdomen Press Z-axisY-axis Chest Laser Air Pillow for horizontal leveling

Radiosurgery Procedure : stereotactic body frame chest and leg mark Immobilization and reference marking Check diaphragm movement CT simulation Treatment planning Verification CT before Treatment Verification and treatment delivery : fluoroscopy with/without diaphragm controller : 3mm thickness around mass involving whole lung : Day 1 and Day 3 : Gy/ fx : 4 consecutive days

Patient Characteristics & Set-up Accuracy GenderMale 70 (77%)Female 21 (23%) AgeMedian 66 years (range 9-89) Tumor diameterMedian 23 mm (range 8-46) Primary sitePrimary lung cancer38 (Salvage treatment)17 (Salvage treatment)17 Metastatic lung cancer53 Primary lung ca.T1N0 13T2N0 8 (n=21)SCC 11 Adenoca. 6 NOS 4 (n=21)SCC 11 Adenoca. 6 NOS 4 Set-up accuracyX-axis mean 2.7 mm error Y-axis mean 3.4 mm error Z-axis mean 3.8 mm error

Results One-year PFS ; 90% Two-year PFS ; 81% Months Survival (%) Months Survival (%) ( p=0.220 ) 74%79% 30Gy 82%94% >40Gy 2YPFS1YPFS Local Progression-free Survival Response of SRS CR20 pts. (22%) PR55 pts. (60%)

1. SRS for moving organ including Lung is proved to be feasible and practical. 2. The preliminary experience of the stereotactic body frame based SRS appeared safe and promising treatment modality for the local management of primary or metastatic lung tumors The optimum total dose and fractionation schedule used should be determined after the longer follow-up of these results. Summary