S839
Clinical - Lung
ESTRO 2026
our single-institution experience treating central and peripheral lung tumors adjacent to the chest wall using SBRT at 60 Gy in 8 fractions (fx). We hypothesized that this regimen, with a biologically effective dose (BED) >100 Gy, would achieve high local control with low toxicity across both peripheral and central locations. Material/Methods: Retrospective chart review of 108 patients with 134 lung lesions (110 peripheral and 24 central) treated between 2019-2024 with SBRT 60 Gy/8 fx. Patients had either primary (n = 82) or metastatic (n = 26) lung tumors. 80% of peripheral lesions were directly abutting the chest wall, and 16% had a PTV<1cm away. Data on chest wall pain (graded per CTCAE v5), rib fractures, and pneumonia/pneumonitis were collected. Primary endpoints were local control (LC) and pulmonary/chest wall toxicity; secondary endpoints were overall survival (OS) and progression- free survival (PFS), analyzed using the Kaplan–Meier
Conclusion: This study demonstrates that combining dosimetric, metabolic, and cardiopulmonary imaging biomarkers significantly contributes to the stratification of outcomes. These findings support the integration of quantitative imaging and dose metrics to refine plan optimisation for cardiac substructures and circulating blood exposure in thoracic radiotherapy. References: The study was funded by AIRC Foundation MFAG 274801) Catalano A., et al. (2025, May 2–6). Identifying cardiac substructures influencing survival in stage III NSCLC patients undergoing radiotherapy.Radiotherapy and Oncology (ESTRO 2025, Vienna, Austria), S1–S4434.2) Catalano, A., et al. (2025). Comparative study of HEDOS and EDIC for predicting 2-year survival in locally advanced NSCLC patients undergoing radiotherapy.International Journal of Radiation Oncology, Biology, Physics, 123(1), e144. Keywords: quantitative imaging, cardiopulmonary risk Expanding the use of 60 Gy in 8 fractions SBRT in Central and Peripheral Lung Tumors: Results from a Single Tertiary Care Institution Racha Khodor 1 , Tala Mobayed 1 , Jimmy Sebaaly 1 , Maya Charafeddine 2 , Tarek Al-Bitar 1 , Lara Hilal 1 , Zeina Ayoub 1 , Toufic Eid 1 , Bassem Youssef 1 1 Radiation Oncology, American University of Beirut Medical Center, Beirut, Lebanon. 2 Oncology, American University of Beirut Medical Center, Beirut, Lebanon Purpose/Objective: Stereotactic body radiotherapy (SBRT) is a well- established treatment for patients with primary inoperable lung tumors or oligometastatic lung lesions. The safety of delivering 60 Gy in 8 fractions for central lesions has been established in prospective Digital Poster 4309 trials; however, its use for tumors adjacent to or abutting the chest wall has not been validated, and data regarding potential reduction in chest wall toxicity are limited. This retrospective study reports
method. Results:
Tumor size ranged from 4–60 mm (mean 22 mm). At a median follow-up of 14 months (95% CI 10.3–17.7), the LC rate was 94.4% and the 3-year LC was 82.1%. Mean PFS for primary tumors was 49.5 months (95% CI 45– 54), and median OS was 54 months (95% CI 32.6–95.3), with 3- and 5-year OS rates of 78% and 41.9%, respectively. Among 45 evaluable patients, 2 (4.4%) developed grade 3 chest-wall pain, 6 (7.4%) had rib fractures, and 16 patients developed pneumonia, including 3 with radiation pneumonitis. Conclusion: SBRT delivered at 60 Gy in 8 fractions provided high local control with low rates of severe toxicity for both central and peripheral lung lesions. These findings support the safety of this regimen; however, prospective studies are warranted to further validate its efficacy and safety, particularly for peripheral
lesions adjacent to the chest wall. Keywords: Lung, SBRT, toxicity
Digital Poster 4316 Overall survival following palliative radiotherapy for catastrophic malignant airway events Aly Muhammad Ladak 1 , Hannah Bacon 2 , Micheal McInnis 3,4 , Chris McIntosh 5 , Ryan Daniel 6 , Christopher MKL Yao 6 , C. Jillian Tsai 2 1 Temerty Faculty of Medicine, University of Toronto, Toronto, Canada. 2 Department of Radiation Oncology, University of Toronto, Toronto, Canada. 3 University Medical Imaging Toronto, Toronto General Hospital, Toronto, Canada. 4 Division of Cardiothoracic Imaging, Department of Medical Imaging, University of Toronto, Toronto, Canada. 5 Department of Medical Biophysics,
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