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Volumetric intensity modulated arc therapy for stereotactic body radiosurgery in oligometastatic breast and gynecological cancers: Feasibility and clinical results

  • Authors:
    • Gabriella Macchia
    • Francesco Deodato
    • Savino Cilla
    • Gabriella Torre
    • Giacomo Corrado
    • Francesco Legge
    • Maria Antonietta Gambacorta
    • Luca Tagliaferri
    • Samantha Mignogna
    • Giovanni Scambia
    • Vincenzo Valentini
    • Alessio G. Morganti
    • Gabriella Ferrandina

  • View Affiliations

  • Published online on: August 18, 2014     https://doi.org/10.3892/or.2014.3412
  • Pages: 2237-2243
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Abstract

In the present study, the preliminary results of the first stereotactic body radiosurgery (SRS) experience with volumetric intensity modulated arc therapy (VMAT) in oligometastatic breast and recurrent gynecological tumors (OBRGT) are reported in terms of feasibility, toxicity and efficacy. Patients were treated in a head-first supine treatment position on a customized body frame immobilization shell. SRS-VMAT treatment plans were optimized using the ERGO++ treatment planning system. Response assessment was performed 8-12 weeks after treatment by morphologic imaging modalities, or if feasible, also by functional imaging. Thirty-six lesions in 24 consecutive patients (median age, 63 years; range, 40-81) were treated: 13.9% had primary or metastatic lung lesions, 30.5% had liver metastases, 36.1% had bone lesions, 16.7% had lymph node metastases and 2.8% had a primary vulvar melanoma. The median dose was 18 Gy (BED2 Gy, α/β: 10=50.4 Gy), the minimal dose was 12 Gy (BED2 Gy, α/β: 10=26.4 Gy) and the maximal dose was 28 Gy (BED2 Gy, α/β: 10=106.4 Gy). Seven patients (29.2%) experienced acute toxicity, which however was grade 2 in only 1 case. Moreover, only 3 patients (12.5%) developed late toxicity of which only 1 was grade 2. Objective response rate was 77.7% including 16 lesions achieving complete response (44.4%) and 12 lesions achieving partial response (33.3%). The median duration of follow-up was 15.5 months (range, 6-50). Recurrence/progression within the SRS-VMAT treated field was observed in 6 patients (total lesions=7) with a 2-year inside SRS-VMAT field disease control expressed on a per lesion basis of 69%. Recurrence/progression of disease outside the SRS-VMAT field was documented in 15 patients; the 2-year outside SRS-VMAT field metastasis‑free survival, expressed on a per patient basis, was 35%. Death due to disease was documented in 6 patients and the 2-year overall survival was 58%. Although the maximum tolerated dose was not reached, SRS-VMAT resulted in positive early clinical results in terms of tumor response, local control rate and toxicity.
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November-2014
Volume 32 Issue 5

Print ISSN: 1021-335X
Online ISSN:1791-2431

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  • CiteScore: 8.5
  • CiteScore Rank: Q1: #74/404 Oncology
  • Source Normalized Impact per Paper (SNIP): 0.719
  • SCImago Journal Rank (SJR): 0.864
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Spandidos Publications style
Macchia G, Deodato F, Cilla S, Torre G, Corrado G, Legge F, Gambacorta MA, Tagliaferri L, Mignogna S, Scambia G, Scambia G, et al: Volumetric intensity modulated arc therapy for stereotactic body radiosurgery in oligometastatic breast and gynecological cancers: Feasibility and clinical results. Oncol Rep 32: 2237-2243, 2014.
APA
Macchia, G., Deodato, F., Cilla, S., Torre, G., Corrado, G., Legge, F. ... Ferrandina, G. (2014). Volumetric intensity modulated arc therapy for stereotactic body radiosurgery in oligometastatic breast and gynecological cancers: Feasibility and clinical results. Oncology Reports, 32, 2237-2243. https://doi.org/10.3892/or.2014.3412
MLA
Macchia, G., Deodato, F., Cilla, S., Torre, G., Corrado, G., Legge, F., Gambacorta, M. A., Tagliaferri, L., Mignogna, S., Scambia, G., Valentini, V., Morganti, A. G., Ferrandina, G."Volumetric intensity modulated arc therapy for stereotactic body radiosurgery in oligometastatic breast and gynecological cancers: Feasibility and clinical results". Oncology Reports 32.5 (2014): 2237-2243.
Chicago
Macchia, G., Deodato, F., Cilla, S., Torre, G., Corrado, G., Legge, F., Gambacorta, M. A., Tagliaferri, L., Mignogna, S., Scambia, G., Valentini, V., Morganti, A. G., Ferrandina, G."Volumetric intensity modulated arc therapy for stereotactic body radiosurgery in oligometastatic breast and gynecological cancers: Feasibility and clinical results". Oncology Reports 32, no. 5 (2014): 2237-2243. https://doi.org/10.3892/or.2014.3412