Focal, high dose, and fractionated modified stereotactic radiation therapy for lung carcinoma patients: A preliminary experience

Minoru Uematsu, Akira Shioda, Kazuhiko Tahara, Toshiharu Fukui, Fuyumi Yamamoto, Gentaro Tsumatori, Yuichi Ozeki, Teruhiro Aoki, Masazumi Watanabe, Shoichi Kusano

Research output: Contribution to journalArticlepeer-review

287 Citations (Scopus)


BACKGROUND. Stereotactic radiation therapy is highly effective in the treatment of small brain metastases, regardless of the histology. This suggests that small extracranial malignancies may be curable with similar radiation therapy. The authors developed a novel treatment unit for administering such therapy. METHODS. The unit consisted of a linear accelerator (linac), an X-ray simulator (XS), computed tomography (CT), and a table. The gentry axes of the three machines were coaxial and could be matched by rotating the table. Patients were instructed to perform shallow respiration with oxygen. The motion of the tumor was monitored with the X-S. When the motion was slight enough, the table was rotated to the CT. To include all geometric movement on the CT images, each scan was made while the patient was performing shallow respiration. After the CT positioning, the table was rotated to the linac, and non-coplanar treatment was given. Beginning in October 1994, 45 patients with 23 primary or 43 metastatic lung carcinomas were treated. Radiation doses at the 80% isodose line were 30-75 gray in 5-15 fractions over 1-3 weeks with or without conventional radiation therapy. RESULTS. The treatment was performed with no or minimal adverse acute symptoms. The deity treatment time was short. During a median follow- up of 11 months, local progression occurred in 2 of 66 lesions. Interstitial changes in the lung were limited. CONCLUSIONS. With this unit and procedure, focal radiation therapy similar to stereotactic radiation therapy is possible for extracranial sites. The preliminary experience appeared safe and promising, and further exploration of this approach is warranted.

Original languageEnglish
Pages (from-to)1062-1070
Number of pages9
Issue number6
Publication statusPublished - 1998 Mar 15


  • Extracranial
  • Focal
  • Fractionated
  • High dose
  • Lung carcinoma
  • Radiation therapy
  • Stereotactic
  • Treatment unit

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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