OBJECTIVE
To improve treatment outcomes and quality of life in patients with solitary lung metastases deemed functionally inoperable considered as functionally inoperable.
MATERIAL AND METHODS
Stereotactic radiation therapy (SRT) was performed on inoperable patients (45 individuals) with solitary lung metastases. Patient age ranged from 27 to 81 years, with 27 (60%) males and 18 (40%) females. The primary tumor was localized in the lungs in 21 (47%) patients, gastrointestinal tract in 8 (18%), breast in 4 (9%), cervix in 3 (7%), skin melanoma in 3 (7%), oropharyngeal region in 2 (4%), soft tissue sarcoma in 2 (4%), genitourinary system in 2 (4%). Histologically, adenocarcinoma was identified in 21 (47%) patients, squamous cell carcinoma in 13 (29%), melanoma in 3 (7%), sarcoma in 3 (7%), ductal carcinoma in 2 (4%), small cell carcinoma, lobular carcinoma, and seminoma each in 1 (2%) patient. The radiation volume was determined based on the principle GTV=CTV→PTV(+3 mm). SRT was administered daily at peripheral targets with a dose per fraction of 15 Gy to a total dose of 45—60 Gy, and at centrally located targets with a dose per fraction of 8 or 10 Gy to a total dose of 30—40 Gy, BED10=72—112 Gy. All SRT sessions were performed using Elekta accelerators during inhalation with the ABC breathing control system. Target positioning was verified before each radiation fraction (XVI).
RESULTS
All patients completed the treatment course without signs of radiation reactions or complications. During the follow — up period (median 38.9 months), no signs of continued growth or recurrence in the radiation field were observed in any patient; one-year local control was 100%. Radiation pneumonitis (RTOG1) was detected in 24.4% of patients after completion of SRT. One-year overall survival was 95.6%, and three-year survival was 68.9%. The study is ongoing.
CONCLUSION
Based on treatment outcomes, high local control, and absence of severe complications, SRT appears to be highly effective in treating patients with solitary lung metastases.
