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Jared Deck,1 Gary Eastwick,1 Jody Sima,2 Amanda Raymond,1 Jeffrey Bogart,1 Paul Aridgides11Department of Radiation Oncology, SUNY Upstate Medical University, Syracuse, NY, USA; 2Department of Pediatrics, SUNY Upstate Medical University, Syracuse, NY, USAPurpose: To report a case series of 3 pediatric patients treated with Stereotactic Body Radiation Therapy (SBRT) for lung metastases.Patients and methods: Three patients (ages 9, 11, and 21) received SBRT for rhabdoid tumor, Ewing sarcoma, and Wilms tumor histologies, respectively. SBRT doses were 37.5–50Gy in 3–5 fractions treating twelve lesions.Results: Three patients (ages 9, 11, and 21) received photon SBRT for pulmonary metastases. The patients were as follows: 1) 21-year-old male with favorable histology Wilms tumor and 1 lesion treated, 2) 11-year-old female with Ewing sarcoma and 1 lesion treated for relapse after previous whole lung radiation (15Gy), and 3) 9-year-old female with rhabdoid tumor of the left thigh with 10 lesions treated over a two-year period. Median dose delivered was 40Gy (range, 37.5–50Gy), delivered in a median of 4 fractions (range, 4–5) of a median of 10Gy per fraction (range, 9.4–10Gy). Within a minimum follow-up of 1.9years (range 1.9–4years), local control for all 13 treated metastases is 100% without any observed acute toxicities. One possible late toxicity (grade 2 rib fracture) developed 1.3years following SBRT for treatment of a peripheral lesion (rhabdoid tumor) in an area of disease progression and was managed conservatively. Two patients are surviving 2.9years (Wilms tumor) and 1.9years (Ewing sarcoma) after SBRT, and one (rhabdoid tumor) expired 2years after her final course (4years after initial SBRT). Two patients (rhabdoid tumor and Ewing sarcoma) suffered disease progression outside of the treated lesions and one patient (Wilms tumor) is without evidence of disease and has not required whole lung irradiation or further systemic therapy.Conclusion: SBRT appears effective and well tolerated for pediatric lung ... |
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