S803
Clinical - Lung
ESTRO 2026
Keywords: radiation pneumonitis, lobe-specific DVH parameter
single-fraction SBRT for primary tumors, 3 squamous, 10 adenocarcinoma; in 3 cases biopsy could not be performed due to severe comorbidities. The remaining 14 patients were treated for lung oligometastases: 6 from colorectal cancer, 3 oesophageal, 2 non-small cell lung cancer, one bladder and 2 endometrial cancer. In 30% of cases, SBRT was delivered with ongoing systemic therapy. Treatment was well tolerated, with 90% of patients free from any acute toxicity; acute G1– G2 dysphagia or chest pain occurred in 3 patients, no G ≥ 3 events. SUVmax significantly decreased post-RT (p=0,00001), confirming strong metabolic response, with no evidence of local failures at the time of the analysis, with a median follow-up of 6.3 months (range, 5-18 months). 1-year DPFS and OS were respectively 90% and 96.7%. Cox analysis suggested higher post-RT SUVmax tended to predict worse DPFS (HR 1.8; p=0.09) Conclusion: For elderly patients with a relevant burden of comorbidities, in the case of isolated lung malignancies, single-fraction SBRT achieved remarkable metabolic response with excellent short- term tolerance and survival. Although limited by small sample-size and few events, these findings support the feasibility and effectiveness of single-fraction SBRT in selected patients. Keywords: stereotactic radiotherapy; single fraction; lung Image-based analysis of dose-survival associations in lung radiotherapy following heart dose limit implementation within the RAPID-RT study Tom Marchant 1,2 , Kathryn Banfill 3 , Catharine Morgan 4 , Alan McWilliam 2 , Marcel van Herk 2 , Corinne Faivre- Finn 2,3 , Gareth Price 2 1 Christie Medical Physics & Engineering, The Christie NHS Foundation Trust, Manchester, United Kingdom. 2 Division of Cancer Sciences, The University of Manchester, Manchester, United Kingdom. 3 Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, United Kingdom. 4 Division of Informatics, Imaging and Data Sciences, The University of Manchester, Manchester, United Kingdom Poster Discussion 2954
Digital Poster 2881 Single-fraction SBRT with Radixact for lung malignancies: early outcomes of a single-center experience Francesco Cuccia 1 , Marina Campione 2 , Gianluca Mortellaro 1 , Salvatore D'Alessandro 1 , Giuseppe Failla 3 , Alba La Sala 4 , Giuseppe Arcoleo 5 , Michele Gallo 6 , Livio Blasi 7 , Francesco Verderame 8 , Giuseppe Ferrera 1 1 Radiation Oncology, ARNAS Civico Hospital, Palermo, Italy. 2 Clinical Research, ARNAS Civico Hospital, Palermo, Italy. 3 Pneumology Unit, ARNAS Civico Hospital, Palermo, Italy. 4 Bronchial Endoscopy Unit, ARNAS Civico Hospital, Palermo, Italy. 5 Pneumology Unit, Villa Sofia-Cervello Hospital, Palermo, Italy. 6 Bronchial Endoscopy Unit, Villa Sofia-Cervello Hospital, Palermo, Italy. 7 Medical Oncology, ARNAS Civico Hospital, Palermo, Italy. 8 Medical Oncology, Villa Sofia-Cervello Hospital, Palermo, Italy Purpose/Objective: Stereotactic radiotherapy (SBRT) represents an established treatment option for isolated lung nodules, both in the primary setting and in oligometastatic patients. As fractionated schedules are routinely reported in daily clinical practice, the use of single-fraction stereotactic treatments is less described in the literature. Material/Methods: This is a mono-institutional retrospective experience of inoperable patients with small lung lesions, both primary tumors and oligometastases treated with single fraction SBRT performed with helical tomotherapy linac. Data were prospectively collected. 18F-FDG-PET scans were compared to assess metabolic response. Acute and late toxicity were scored by CTCAE v5.0; local control (LC), distant progression-free survival (DPFS), and overall survival (OS) were estimated using Kaplan–Meier and Cox Thirty consecutive patients (median age=76.3 years, range 57-87 – M=19;F=11) with isolated small lung lesions (median size=2.15 cm, range 1-3.7) were treated with single-fraction SBRT performed with Radixact system for a median total dose of 26 Gy (range, 20-30 Gy). Four patients had a pacemaker during radiotherapy, with 9 lesions located in the left lung, five patients were in continuous oxygen-therapy. Nodules were mainly located in the superior lobe (53%), followed by lower lobe in 40% and medium in models. Results: 7%, for a total of 10 peripheral and 20 centro- parenchimal lesions.Overall, 16 patients received
Purpose/Objective: Previous voxel-based analysis (VBA) of lung
radiotherapy (RT) data identified the heart-base as a region where higher dose correlated with poorer survival [1]. In April 2023, our centre implemented a maximum dose objective for a cardiac avoidance area (CAA) encompassing this region, within the RAPID-RT study [2]. Here we apply VBA to patients treated
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