Spatially Fractionated Radiation Therapy for Palliation in Patients With Large Cancers: A Retrospective Study

IF 2.2 Q3 ONCOLOGY

Advances in Radiation Oncology Pub Date : 2024-10-31 DOI:10.1016/j.adro.2024.101665

Federico Iori MD , Valeria Trojani MSc , Alice Zamagni PhD , Patrizia Ciammella MD , Mauro Iori PhD , Andrea Botti MSc , Cinzia Iotti MD

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Abstract

Purpose

Spatially fractionated radiation therapy (SFRT) is an irradiation technique developed to improve large cancer response. Although preliminary studies report highly positive results, data are still limited. The aim of this retrospective monocentric study was to investigate SFRT safety and activity.

Methods and Materials

We analyzed all patients who underwent SFRT as a palliative treatment for large solid extracranial cancer (>4.5 cm) at our institution. The primary endpoint was objective response rate assessment at 3 months. Additionally, patients’ antalgic response, target volume reduction, and performance status modification were measured. Toxicity data were recorded.

Results

From November 2021 to August 2023, 20 consecutive patients (20 lesions) underwent SFRT. We prescribed a minimum dose of 20 Gy in 5 fractions to 95% of the Planning Target Volume (PTV_20) and a minimum dose of 50 Gy to 50% of the sphere volume. The median beam-on time was 5 minutes (IQR_1-3, 4-7 minutes; range, 3-16 minutes). Patients’ median age was 70 years (range, 18-85 years). The median lesion volume was 560.4 cm3 (IQR_1-3, 297.4-931.5 cc; range, 168.3-3838.3 cm3). Of the 20 patients, 14 and 10 were alive at 3 and 6 months, respectively. The 3-month objective response rate was 79% (95% CI, 49%-95%), with a median target volume reduction of 54% (IQR_1-3, 32%-69%; range, 6%-80%). At 6 months, all patients were free from local disease progression. All patients reported an antalgic response with a rapid onset. All treatment-related toxicities occurred within 1 month after SFRT and quickly recovered. No acute toxicity ≥ grade 3 and late toxicity was reported. No patient experienced a worsening in performance status.

Conclusions

Our results provide further evidence supporting SFRT as a safe and promising option for palliative patients affected by large neoplastic lesions.

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来源期刊

Advances in Radiation Oncology Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

4.60

自引率

4.30%

发文量

208

审稿时长

98 days

期刊介绍： The purpose of Advances is to provide information for clinicians who use radiation therapy by publishing: Clinical trial reports and reanalyses. Basic science original reports. Manuscripts examining health services research, comparative and cost effectiveness research, and systematic reviews. Case reports documenting unusual problems and solutions. High quality multi and single institutional series, as well as other novel retrospective hypothesis generating series. Timely critical reviews on important topics in radiation oncology, such as side effects. Articles reporting the natural history of disease and patterns of failure, particularly as they relate to treatment volume delineation. Articles on safety and quality in radiation therapy. Essays on clinical experience. Articles on practice transformation in radiation oncology, in particular: Aspects of health policy that may impact the future practice of radiation oncology. How information technology, such as data analytics and systems innovations, will change radiation oncology practice. Articles on imaging as they relate to radiation therapy treatment.