{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T09:32:08Z","timestamp":1740130328465,"version":"3.37.3"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2022,12,6]],"date-time":"2022-12-06T00:00:00Z","timestamp":1670284800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,3,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Accelerated hypofractionated radiotherapy with 3\u00a0Gy per fraction is routinely performed for central lung tumors in Japan. However, the tolerable doses to mediastinal organs at risk during this procedure are unclear. This study aimed to clarify the rate of toxicities and tolerable doses to mediastinal organs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients treated with accelerated hypofractionated radiotherapy using a total dose of 60\u201375\u00a0Gy, with 3\u00a0Gy per fraction, for central lung tumors (July 2009\u2013April 2021) were retrospectively reviewed. We extracted patients who received \u226530\u00a0Gy irradiation to each mediastinal organ and analyzed dosimetric factors, including doses to 0.03, 0.5, 1, 4 and 10\u00a0mL of each organ, in relation to grade 3\u20135 toxicities, except for radiation pneumonitis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 251 organs in 91 (ultra-central, 24) lesions were analyzed, with a median follow-up duration of 26\u00a0months (range, 4\u201394). The prescribed doses were 75\/72\/69\/66\/63\/60\u00a0Gy for 52\/14\/16\/3\/2\/4 lesions, respectively. Grade 3 bronchopulmonary hemorrhage was confirmed in two (2.2%) patients, whose tumors were located ultra-centrally. The two patients with toxicity received up to 74.5 and 71.6\u00a0Gy to the bronchus. Among patients who received 70\u00a0Gy or more to the bronchus, the incidence rate was 7% (2\/28 patients).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The rate of severe toxicities was low (2.2%). Although we did not identify the dose tolerance of the organs, because of the low incidence rate, we did note that doses of &amp;gt;70\u00a0Gy to the bronchus were likely to cause bronchopulmonary hemorrhage.<\/jats:p><\/jats:sec>","DOI":"10.1093\/jjco\/hyac181","type":"journal-article","created":{"date-parts":[[2022,12,7]],"date-time":"2022-12-07T13:33:57Z","timestamp":1670420037000},"page":"237-244","source":"Crossref","is-referenced-by-count":0,"title":["Accelerated hypofractionated radiotherapy with 3\u00a0Gy per fraction for central\/ultra-central lung tumors: toxicity to mediastinal organs"],"prefix":"10.1093","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5792-3795","authenticated-orcid":false,"given":"Kei","family":"Ito","sequence":"first","affiliation":[{"name":"Division of Radiation Oncology, Department of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital , Tokyo , 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