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Toxicity and Efficacy of Stereotactic Body Radiotherapy for Ultra-central Lung Tumours: a Single Institution Real Life Experience


 Purpose: The use of stereotactic body radiotherapy (SBRT) to treat ultra-central lung tumours remains more controversial than for peripheral and central tumours. We carried out a study about SBRT in patients with ultra-central lung tumours treated in our Cancer Centre. Our objectives were to assess toxicities, local control (LC) rate and survival data.Methods: We conducted a retrospective and monocentric study about 74 patients with an ultra-central lung tumour, consecutively treated between 2012 and 2018. Ultra-central tumours were defined as tumours whose PTV (planning target volume) overlapped one of the following organs at risk (OAR): the trachea, right and left main bronchi, intermediate bronchus, lobe bronchi, oesophagus, heart. Patients with primary or secondary tumour were enrolled in the study.Results: Median follow-up was 25 months. Two patients (2.7%) showed grade 3 toxicity. No grade 4 or 5 toxicity was observed. Eleven per cent of patients experienced primary local relapse. Local control rate was 96.7% at 1 year and 87.6% at 2 years. Median progression free survival (PFS) was 12 months. Median overall survival (OS) was 31 months. Conclusions: SBRT for ultra-central tumours remains safe and effective. Thus, SBRT can be considered to be well tolerated as long as protecting organs at risk remains treatment planning priority. Besides, as the results of ongoing prospective trial have not been published yet, SBRT for ultra-central tumours should be performed with caution.