S825
Clinical - Lung
ESTRO 2026
using high-energy photons) of (2) centrally or ultra- centrally located lung tumours and (3) outcome parameters were included. Trials were omitted if certain of the above-mentioned endpoints were not available. A meta-analysis of proportions was performed using random-effect models. I2 was calculated to describe the heterogeneity. Results: 57 retrospective and 12 prospective trials were included, encompassing in total 3,672 and 1,509 patients with central and ultra-central lung tumours. The median follow-up was 22.7 (range: 10.6 – 93.6) and 21.2 (8.6 – 93.6) months for centrally and ultra- centrally located lesions. The calculated mean biological effective dose (BED3 and BED10) was 185.2 (± 44.6) and 94.5 (± 19.1) Gy in ultra-centrally and 214.1 (± 47.4) and 102.7 (± 15.4) Gy in centrally located lung tumours. For ultra-central lesions the median overall survival was 28.0 (12.0 – 64.5) months compared to 39.4 (19.0 – 57.0) months in central lesions with highest efficacy of SBRT with 60 Gy in 8 fractions. Overall, pooled grade 3-5 toxicity was low for both localizations. The most frequently reported fatal complication in ultra-centrally (Fig. 1) vs. centrally located (Fig. 2) tumours was haemorrhage with an estimated proportion of 0.48 [range: 0 – 14.89; CI 95% = 0.00 – 1.68] vs. 0.12 [range: 0 – 7.09; CI 95% = 0.00 – 0.46]. Neither BED3 nor BED10 correlated statistically significant with the incidence of toxicity in either subgroup.
modality. Conclusion:
NHD significantly improved local control in lung oligometastases treated with 48 Gy in 4 fractions, without increasing side effects. When minimum target coverage and dose guidance for organs of interest are maintained, selective dose intensification within the target may enhance tumor control and support individualized SBRT optimization. Keywords: Dose prescription, Lung oligometastases, SBRT Poster Discussion 3854 Safety of SBRT in centrally and ultra-centrally located lung tumours: A PRISMA-based systematic review and meta-analysis Shari Wiegreffe 1 , Sonja Adebahr 2 , Tanja Schimek- Jasch 2 , Julian Philipp Layer 1,3 , Cas Stefaan Dejonckheere 1 , Gustavo Renato Sarria 1 , Davide Scafa 1 , Youness Nour 1 , Lara Aylin Caglayan 1 , Dimos Baltas 2 , Christos Moustakis 4 , Nils Henrik Nicolay 4 , Andreas Rimner 2 , Anca-Ligia Grosu 2 , Ursula Nestle 5,2 , Eleni Gkika 1 1 Department of Radiation Oncology, University Hospital Bonn, Bonn, Germany. 2 Department of Radiation Oncology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. 3 Institute of Experimental Oncology, University Hospital Bonn, Bonn, Germany. 4 Department of Radiation Oncology, University Hospital Leipzig, Leipzig, Germany. 5 Department of Radiation Oncology, Kliniken Maria Hilf GmbH, Mönchengladbach, Germany Purpose/Objective: Non-small cell lung cancer (NSCLC) is one of the leading causes of cancer-related mortality worldwide with surgery as standard of care for early-stage disease 1. For functionally or medically inoperable patients or those declining surgery, stereotactic body radiation therapy (SBRT) offers an effective curative treatment alternative, however can be associated with severe side effects, especially for patients with tumours located centrally and ultra-centrally 2–4. This review aims to provide insights into outcomes and toxicity of SBRT, therefore providing evidence for treatment recommendations of this specific subgroup of tumours. Material/Methods: According to PRSIMA-guidelines, Pubmed/MEDLINE was searched with the term ["Carcinoma, Non-Small- Cell Lung"[Mesh] AND ("Radiosurgery"[Mesh] OR "SABR" OR "stereotactic ablative radiotherapy" OR "SBRT" OR "stereotactic body radiotherapy")]. Trials reporting on (1) SBRT (defined as > 3 Gy per fraction
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