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• W2519144640 abstract "Pulmonary metastasetomy is known to be able to improve the survival in selected patients with metastatic lung disease. We analyzed the short term treatment results of simultaneous multitarget irradiation using tomotherapy in the primary or secondary lung cancer patients to know whether radiation therapy could substitute pulmonary operation. We treated thirty two patients using tomotherapy for 1 year after our machine installation in 2005. The original malignancies were hepatocelluar carcinoma, lung cancer, breast cancer, colorectal cancer, invasive thymoma, thyroid cancer, pancreas cancer, endometrial cancer, renal cell carcinoma, oral cavity cancer and Ewing's sarcoma. The average number of pulmonary targets was 5.1 (range: 1-15). The unilateral pulmonary lesions were in eleven patients (34.4%) and bilateral lesions in 21 patients (65.6%). In 12 patients (37.5%), synchronous extrapulmonary targets were present. Twenty six patients (81.3%) had been treated with chemotherapy for pulmonary metastasis before tomotherapy. The median number of cycles of systemic chemotherapy was nine (range 1– 21) and the median interval between chemotherapy and tomotherapy was 2 months (range: 1-36 months). Four patients (12.5%) had a past history of mediastinal radiotherapy. We immobilized the patients with BodyFix system (Medical Intelligence, Germany) and defined the GTV (gross tumor volume) and PTV (planning target volume: GTV + 0.5 ˜ 1.5cm) in chest CT scan and their median doses were 50.0±5.99 Gy and 40.0±7.03 Gy with 3-20 fractionations, respectively. Median treatment duration was 14days (range: 3-28 days). Before treatment, we always confirmed the positions of the targets and the isodose distribution after checking megavoltage CT scan. To decrease the risk of pulmonary toxicity, we tried to decrease the values of mean lung dose, median lung dose and V25 as low as possible. RECIST (Response Evaluation Criteria In Solid Tumors) method and CTCAE (Common Terminology Criteria for Adverse Event) method were used to evaluate the post-treatment response and pulmonary toxicity. The number of eligible patients was thirty (93.8%) whom we could follow up more than 1 month. Median follow up period was 6 month (1-13 months). The rates of complete and partial response were 3.3% and 46.7% in 1 month and 15.6% and 36.7% in 3 months after treatment. The overall response rate was 52.3% in 3 months after treatment. The data of pulmonary dosimetric analysis were that in right and left lung, mean lung doses were 13.89±6.70 Gy and 15.20±5.44 Gy, median lung doses were 12.52±6.27 Gy and 13.43±6.00 Gy and the values of V25 were 13.76±10.04% and 15.25±8.77%. Radiation pneumonitis or pulmonary fibrosis was appeared in 10 patients (33.3%) but all pulmonary toxicities were less than grade III. We can suggest that tomotherapy for multiple lung metastasis was a safe and effective treatment modality but we need study about further analysis of survivals, chronic complications and influencing factors through long term follow up in larger group of patients to make up the limitation of our experience." @default.
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• W2519144640 date "2007-08-01" @default.
• W2519144640 modified "2023-09-30" @default.
• W2519144640 title "P1-134: Clinical Experience of Simultaneous Multitarget Irradiation using Tomotherapy in Pulmonary Metastasis" @default.
• W2519144640 doi "https://doi.org/10.1097/01.jto.0000283748.85598.d9" @default.
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