Practical Radiation Oncology最新文献

{"title":"Best Practice Guidelines for Use of Reference Points in Radiation Oncology Information Systems to Aggregate Longitudinal Dosimetric Data","authors":"Alon Witztum PhD ,&nbsp;Younes Jourani Ir ,&nbsp;Emily Y. Hirata PhD ,&nbsp;Todd McNutt PhD ,&nbsp;Tony Tadic PhD ,&nbsp;Kristy K. Brock PhD ,&nbsp;David S. Hong MD ,&nbsp;Michelle E. Howard PhD ,&nbsp;Andra V. Krauze MD ,&nbsp;Peter A. Balter PhD ,&nbsp;Abigail L. Stockham MD ,&nbsp;Elizabeth L. Covington PhD ,&nbsp;Ying Xiao PhD ,&nbsp;Richard Popple PhD ,&nbsp;Charles S. Mayo PhD","doi":"10.1016/j.prro.2024.09.016","DOIUrl":"10.1016/j.prro.2024.09.016","url":null,"abstract":"<div><h3>Purpose</h3><div>Tracking patient doses in radiation oncology is challenging because of disparate electronic systems from various vendors. Treatment planning systems (TPS), radiation oncology information systems (ROIS), and electronic health records (EHR) lack uniformity, complicating dose tracking and reporting. To address this, we examined practices in multiple radiation oncology settings and proposed guidelines for current systems.</div></div><div><h3>Methods and Materials</h3><div>A survey was conducted among members of various professional groups to understand dose reporting practices in TPS, ROIS, and EHR systems. The aim was to identify consistent components and develop guidelines.</div></div><div><h3>Results</h3><div>We identified 6 treatment scenarios where current ROIS defaults fail to accurately represent dose totals. A standardized approach involving 3 reference point types – primary treatment plan reference, dose check, and prescription tracking – was proposed to address these scenarios. Standardizing naming conventions for reference points was also recommended for easier integration with EHRs. The approach requires minimal modifications to existing systems and facilitates easier data transfer and display in EHRs.</div></div><div><h3>Conclusions</h3><div>Standardizing reference points in commercial TPS and ROIS can bridge infrastructure gaps and improve dose tracking in complex clinical scenarios. This standardization, aligned with the American Association of Physicists in Medicine's Task Group (TG) 263, paves the way for continual development of automated, standardized, interoperable tools, enhancing the ease of sharing reference point information.</div></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 3","pages":"Pages 290-299"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dose Planning and Radiation Optimization for Thoracic Conventional, Twice Daily, and Stereotactic Radiation Therapy: A Delphi Consensus From a National Survey of Practitioners","authors":"Julius Weng MD ,&nbsp;Jeff Ryckman MD ,&nbsp;Matthew S. Katz MD ,&nbsp;Hina Saeed MD ,&nbsp;Christopher Estes MD ,&nbsp;Issam El Naqa PhD ,&nbsp;Amy Moreno MD ,&nbsp;Sue S. Yom MD, PhD ,&nbsp;Dose Planning and Radiation Optimization (Dose-PRO) Consensus Group","doi":"10.1016/j.prro.2024.11.006","DOIUrl":"10.1016/j.prro.2024.11.006","url":null,"abstract":"<div><h3>Purpose</h3><div>We sent surveys to a large number of radiation oncologists with active thoracic cancer practices and applied the Delphi method over 3 rounds to generate consensus dose-volume histogram metrics. We used these results to create consensus-based organs-at-risk dose constraints and target goal templates for practical implementation.</div></div><div><h3>Methods and Materials</h3><div>In this institutional review board-approved study, data were collected using REDCap electronic data capture on a secure server. Radiation oncologists identified from the Accreditation Council for Graduate Medical Education-accredited departments’ websites were asked to confirm their self-identification as thoracic radiation oncologists and nominate other respondents. All invitees were asked to complete 3 rounds of questions related to normal tissue constraints, target coverage metrics, prescribing practices, and other planning considerations. Preliminary consensus statements were presented in the second round of surveys for voting on a 5-point Likert scale. The third and last round of surveys presented the iterated consensus statements and target coverage metric statements for final voting. The high consensus was predefined as ≥ 75% agreement.</div></div><div><h3>Results</h3><div>Eighty-three (42.8%) of 194 invitees completed at least 1 round of surveys. The group included a diversity of gender, geography, and clinical settings. Response rates were 83%, 57%, and 55%, respectively, for the 3 rounds. By the end of the process, 48 of 96 (50%) originally proposed normal tissue dose constraint statements were iterated to consensus, and 5 of 7 (71%) proposed target coverage metric statements achieved consensus. These were used to create crowdsourced treatment planning templates.</div></div><div><h3>Conclusion</h3><div>This study achieved broad-based consensus-building on ideal and acceptable dose constraints for conventional, twice-daily, and stereotactic thoracic radiation therapy. Future directions could include extending this approach to other disease sites, studying the influence of widespread implementation on treatment planning, or facilitating the development of community consensus around emergent or controversial questions.</div></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 3","pages":"Pages e267-e275"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparison of Radiosurgical Planning Techniques for the Treatment of Trigeminal Neuralgia","authors":"Kati Doxsee MS ,&nbsp;Ian Paddick MSc ,&nbsp;William A. Friedman MD ,&nbsp;Jonathan G. Li PhD ,&nbsp;Alexandra De Leo MD ,&nbsp;Matthew Koch MD ,&nbsp;Frank J. Bova PhD","doi":"10.1016/j.prro.2024.11.014","DOIUrl":"10.1016/j.prro.2024.11.014","url":null,"abstract":"<div><h3>Purpose</h3><div>To survey and analyze the current peer-reviewed literature on physical aspects of radiosurgical treatment of trigeminal neuralgia (TN), and objectively determine the comparative differences between common treatment planning techniques/modalities when variability in computed tomography and magnetic resonance imaging data sets and clinical approaches are minimized.</div></div><div><h3>Methods and Materials</h3><div>Example treatment plans were created from 8 distinct planning approaches on a unique computed tomography and magnetic resonance imaging data set. Treatment plan selection comprised Gamma Knife, physical cone, and multileaf collimator-based plans. The prescription was standardized between plans to 85 Gy at the isocenter, as well as the location of the treatment isocenter. Dose distributions were characterized using multiplanar isodose line comparisons, dose line profiles in 2 dimensions, gradient indices, dimensional and volumetric analysis of 50% and 80% isodose coverage, and maximum (0.1 cc) dose to the brainstem as singularly contoured on the unique imaging data set.</div></div><div><h3>Results</h3><div>Dose coverage, distribution shape, dose line profiles, and gradients differ significantly between Gamma Knife, physical cone, and multileaf collimator-based planning techniques, even when dose prescription, treatment isocenter, and imaging data set/anatomy are identical between treatment plans. Gamma Knife (4 mm collimator) provides the broadest coverage of the trigeminal nerve, most closely approximated by the 5 mm physical cone linear accelerator (LINAC)-based plan. Contrastingly, the smallest cross-sectional coverage in this treatment plan selection was created by the 4 mm LINAC physical cone. All dose distributions were approximately spherical except the 11-arc physical cone LINAC-based plan, which produces a more elongated distribution (broadest adjacent to the brainstem).</div></div><div><h3>Conclusions</h3><div>The selection of a radiosurgical technique for TN should be weighed in the context of differences in dose distributions between treatment techniques, as demonstrated by the plans analyzed in this study. It cannot be assumed that all TN radiosurgical techniques produce the same dose distribution, either to the trigeminal nerve or adjacent normal tissues. Differences between planning techniques may be amplified in real clinical scenarios with differences in clinical approach and anatomy.</div></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 3","pages":"Pages e258-e266"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PROshot: Radiation Alone for Low-risk, Early-stage Breast Cancer, Stereotactic Body Radiation Therapy for Advanced and Recurrent Hepatocellular Carcinoma, and the Role of Cetuximab in Treating Head and Neck Squamous Cell Carcinoma","authors":"Caleb Dulaney MD ,&nbsp;Laura Dover MD, MSPH","doi":"10.1016/j.prro.2025.02.005","DOIUrl":"10.1016/j.prro.2025.02.005","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 3","pages":"Pages 221-224"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143906965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stereotactic Body Radiation Therapy for Primary Lung Cancer and Metastases: A Case-Based Discussion on Challenging Cases","authors":"Colton Ladbury MD ,&nbsp;Baho Sidiqi MD ,&nbsp;Nate Cantrell MD ,&nbsp;Gavin Jones MD ,&nbsp;Karin A. Skalina MD ,&nbsp;Fatemeh Fekrmandi MD ,&nbsp;Therese Y. Andraos MD ,&nbsp;Emile Gogineni DO ,&nbsp;Jennifer Dolan PhD ,&nbsp;Shankar Siva MD, PhD ,&nbsp;Ben Slotman MD ,&nbsp;Percy Lee MD","doi":"10.1016/j.prro.2024.09.012","DOIUrl":"10.1016/j.prro.2024.09.012","url":null,"abstract":"<div><h3>Purpose</h3><div>Data informing the safety, efficacy, treatment logistics, and dosimetry of stereotactic body radiation therapy (SBRT) for lung tumors has primarily been derived from patients with favorably located solitary tumors. SBRT is now considered a standard-of-care treatment for inoperable early-stage non-small cell lung cancer and lung metastases, and therefore extrapolation beyond this limited foundational patient population remains an active source of interest.</div></div><div><h3>Methods and Materials</h3><div>This case-based discussion provides a practical framework for delivering SBRT to challenging, yet frequently encountered, cases in radiation oncology. The cases highlighted herein include the use of SBRT for ultracentral tumors, multiple tumors, and reirradiation. Patient characteristics, fractionation, prescription dose, treatment technique, and dose constraints are discussed. Relevant literature to these cases is summarized to provide a framework for the treatment of similar patients.</div></div><div><h3>Results</h3><div>Treatment of challenging cases with lung SBRT requires many considerations, including treatment intent, fractionation selection, tumor localization, and plan optimization. In such scenarios, patient selection is critical to understanding the risk-benefit profile of an SBRT approach despite significant advances in delivery techniques and safety.</div></div><div><h3>Conclusions</h3><div>A case-based discussion was developed by the Radiosurgery Society to provide a practical guide to the common challenging scenarios noted above affecting patients with lung tumors. A multidisciplinary approach should guide the treatment of such cases to maximize the therapeutic window.</div></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 3","pages":"Pages 262-276"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the ASTRO 2024 Guideline on Partial Breast Irradiation Eligibility in Breast Cancer Patients (KROG 24-01)","authors":"Seok-Joo Chun MD ,&nbsp;Sangjoon Park MD, PhD ,&nbsp;Yong Bae Kim MD, PhD ,&nbsp;Sung-Ja Ahn MD, PhD ,&nbsp;Kyubo Kim MD, PhD ,&nbsp;Kyung Hwan Shin MD, PhD","doi":"10.1016/j.prro.2024.11.007","DOIUrl":"10.1016/j.prro.2024.11.007","url":null,"abstract":"<div><h3>Purpose</h3><div>The American Society for Radiation Oncology (ASTRO) has recently published new guidelines for the eligibility for partial breast irradiation (PBI). This study aims to evaluate the eligibility rates of PBI according to the ASTRO 2017 and 2024 guidelines.</div></div><div><h3>Methods and Materials</h3><div>Patients diagnosed with pTis-T2N0 breast cancer in 2019 from 3 tertiary medical centers were accrued. All patients received standard treatment consisting of breast-conserving surgery followed by radiation therapy. Subsequently, patients were classified according to the ASTRO 2017 and 2024 guidelines.</div></div><div><h3>Results</h3><div>For invasive breast cancer, 785 patients were included, among whom 192 received PBI. Classification according to the ASTRO guidelines showed a substantial increase in the proportion of patients eligible for PBI: 19.2% were classified as “suitable” under the ASTRO 2017 guidelines, while 42.4% were classified as “strongly recommended” under the ASTRO 2024 guidelines. Among 286 patients diagnosed with ductal carcinoma in situ (DCIS), 50 (17.5%) received PBI. The proportion of PBI-eligible patients nearly doubled, from 27.3% under the ASTRO 2017 guidelines to 51.7% under the ASTRO 2024 guidelines. The expanded age criterion from 50 to 40 years and the removal of the clear resection margin requirement were key factors contributing to this substantial increase in both invasive breast cancer and DCIS.</div></div><div><h3>Conclusions</h3><div>The eligibility for PBI has dramatically increased for both invasive breast cancer and DCIS under the ASTRO 2024 guidelines. These findings suggest a potential for increased use of PBI, offering individualized and optimized treatment options in early breast cancer.</div></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 3","pages":"Pages e230-e239"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Masthead/Sub page","authors":"","doi":"10.1016/S1879-8500(25)00076-1","DOIUrl":"10.1016/S1879-8500(25)00076-1","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 3","pages":"Page A1"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143906962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"American Brachytherapy Society Education Committee Technical Report: A Resident's Guide to Evaluation of Prostate High Dose Rate Brachytherapy Treatment Plans.","authors":"Zohaib Sherwani, Ulysses Gardner, Irina Vergalasova, Hong Zhang, Daniel Song, Surendra Prajapati, Pretesh Patel, Mitchell Kamrava, Lara Hathout","doi":"10.1016/j.prro.2025.04.010","DOIUrl":"10.1016/j.prro.2025.04.010","url":null,"abstract":"<p><p>High-dose-rate (HDR) brachytherapy has demonstrated significant clinical efficacy in the management of prostate cancer, facilitating dose escalation in both boost and monotherapy settings. However, recent graduates in radiation oncology report limited exposure to brachytherapy during training, resulting in reduced procedural proficiency and a lack of confidence in performing and assessing brachytherapy treatment plans. This technical report addresses key aspects of plan evaluation within the computed tomography- and magnetic resonance imaging-based workflow for whole-gland prostate HDR brachytherapy, both as monotherapy and as a boost modality. It aims to equip residents and recent graduates with a structured approach to evaluating treatment plans, thereby enhancing their competency and confidence in HDR brachytherapy practice.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simulation Study of Upright Prostate Radiation Therapy: Comparison of Upright and Supine Anatomy and Dose-Volumetric Factors","authors":"Kohei Oguma MSc ,&nbsp;Yoshitake Yamada MD, PhD ,&nbsp;Naoyoshi Koike MD, PhD ,&nbsp;Junichi Fukada MD, PhD ,&nbsp;Minoru Yamada PhD ,&nbsp;Yoichi Yokoyama MD, PhD ,&nbsp;Atsuya Takeda MD, PhD ,&nbsp;Naoyuki Shigematsu MD, PhD ,&nbsp;Masahiro Jinzaki MD, PhD","doi":"10.1016/j.prro.2025.04.007","DOIUrl":"10.1016/j.prro.2025.04.007","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to assess the feasibility of upright radiation therapy for prostate cancer<span>, compared to conventional supine radiation therapy, by quantitatively evaluating anatomic changes and their dosimetric impact through treatment planning simulations based on paired upright and supine positioning computed tomography (CT) images.</span></div></div><div><h3>Methods and Materials</h3><div><span>This study compared pelvic organ anatomies and dose distributions, in hypothetical prostate cancer patients, between upright and supine prostate radiation therapy using paired CT images from asymptomatic volunteers. Anatomic changes in pelvic organ position, shape, volume, and rectal gas were quantitatively evaluated. Prostate radiation therapy was simulated on these CT images for </span>volumetric modulated arc therapy with a prescribed dose of 60 Gy in 20 fractions. Dosimetric comparisons were performed using dose-volume histogram parameters based on a clinical protocol.</div></div><div><h3>Results</h3><div><span>Fifty-one asymptomatic volunteers were registered. Compared to the supine position<span>, pelvic organs in the upright position moved inferiorly (prostate: 2.8 mm ± 5.2, rectum: 2.9 mm ± 5.8, bladder: 3.7 mm ± 6.9, bowel: 25.2 mm ± 18.6; all </span></span><em>P</em> &lt; .001). Rectal gas moved superiorly (4.8 mm ± 11.9; <em>P</em> = .004) and posteriorly (10.7 mm ± 23.5; <em>P</em> = .008). All dose-volume histogram parameters met the dose constraints, and the dose distributions of the upright and supine plans were clinically comparable in terms of organ-at-risk sparing and target coverage (<em>P</em> &gt; .05). In some cases, the rectum curved more posteriorly in the upright position, allowing better sparing of high-dose areas, and the bladder moved inferiorly while expanding in the anterior-posterior direction in the upright position, preventing the small bowel from dropping into the radiation field.</div></div><div><h3>Conclusions</h3><div>Our treatment planning simulation showed that upright radiation therapy for prostate cancer is feasible with a dose distribution comparable to that of conventional supine radiation therapy, despite significant anatomic changes in pelvic organ positioning between the upright and supine patient positions.</div></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 5","pages":"Pages 497-508"},"PeriodicalIF":3.5,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lung Stereotactic Body Radiation Therapy Using Dynamic Conformal Arc Therapy With or Without Flattening Filter Photon Beam: A French Institutional Experience.","authors":"Mickael Preault, Leonor Chaltiel, Jonathan Khalifa, Audrey Keller, Sarah Zahi, Audrey Rabeau, Laure Parent, Carole Massabeau","doi":"10.1016/j.prro.2025.04.006","DOIUrl":"10.1016/j.prro.2025.04.006","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the safety and efficacy of the flattening filter-free (FFF) technique compared with the flattening filter (FF) technique in the context of lung tumor stereotactic body radiation therapy (SBRT).</p><p><strong>Methods and materials: </strong>The study included a total of 101 lung SBRT treatments among 82 consecutive patients. Patients were treated with an FF technique (FF group, n = 47) between 2012 and 2014 and with an FFF technique (FFF group, n = 54) between 2014 and 2016. Our risk-adapted SBRT fractionation protocol based on location (3 or 5 fractions) remained unchanged during the entire study. Treatment plans consisted of a dynamic conformal half-arc, and the dose was prescribed to the 80% isodose line. FFF treatments are delivered 2.33 times faster than FF treatments because of the higher dose rate of the machine.</p><p><strong>Results: </strong>The median follow-up for the 82 patients was 55.4 months, and the median overall survival for all patients was 45.9 months. Local control at 2 years post-SBRT of the 101 lesions was excellent and similar in both groups (97.9% in the FF group vs 98.1% in the FFF group). There were no grade 4 or 5 toxicities and only 4 grade 3 lung toxicities (4.1%) in the FF group (vs none in the FFF group). Three patients in the FFF group versus 1 patient in the FF group had a symptomatic rib fracture. Among patients treated free breathing on a single lesion (n = 65), the local recurrence-free survival at 2 years was 85.7% (95% CI, 62.0-95.2) in the FFF group and 71.4% (95% CI, 52-84.1) in the FF group (P = .139).</p><p><strong>Conclusions: </strong>Patient treatment with lung SBRT using the FFF technique is safe and provides an excellent long-term local control and low toxicity compared with the FF technique.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}