Abstract
BACKGROUND: Stereotactic body radiotherapy (SBRT) is a well-accepted treatment for metastatic and primary lung cancer; however, an optimal regimen is still unclear for ultra central thoracic lesions. The objective of this manuscript is to report the toxicity of SBRT in patients with ultra-central tumors treated with 50 Gy in 5 fractions. MATERIALS AND METHODS: We performed a retrospective review of patients with ultra-central lung lesions treated with SBRT in our institution at the dose of 50 Gy in 5 fractions, delivered every other day. Lesions were defined as ultra-central when the planning target volume (PTV) overlapped the trachea, proximal bronchial tree, great vessels, heart and esophagus. Constraints for organ at risk (OAR) were the ones used in the RTOG-0813 trial. RESULTS: 86 patients were included in this review. The median age was 74 years. The overlapping OAR were: the great vessels in 46 patients (53.4%), heart in 20 (23.2%), tracheobronchial tree in 18 (20.9%) and esophagus in 2 (2.3%). Median follow up was 17 months. The median overall survival was 39 months. There was no SBRT related grade 3 or greater acute or late toxicity. CONCLUSION: In this cohort of patients with ultra-central thoracic lesions treated with 50 Gy in 5 fraction SBRT, no grade 3-5 acute or late toxicity was observed.