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Yusuke Muranishi



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    P1.14 - Radiotherapy (ID 700)

    • Event: WCLC 2017
    • Type: Poster Session with Presenters Present
    • Track: Radiotherapy
    • Presentations: 1
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      P1.14-005 - Development of a Novel Spacer to Reduce Mediastinal Organ Toxicity from Stereotactic Body Radiotherapy (ID 7447)

      09:30 - 16:00  |  Presenting Author(s): Yusuke Muranishi

      • Abstract
      • Slides

      Background:
      Recently, stereotactic body radiotherapy (SBRT) has become available for patients who are at high risk for lung resection. Although SBRT for peripheral lung tumors produces excellent outcomes with low toxicity, it is associated with an increased risk of severe toxicity when used to treat central tumors. We hypothesized that using a spacer designed to provide a predetermined distance between the target lesion and mediastinal organs may reduce adjacent organ toxicity, thereby expanding the indication of SBRT for lung cancer.

      Method:
      We developed a novel silicon-based spacer that imitated the shape of a canine’s left mediastinum. Animal experiments were performed on canine models to evaluate the feasibility, utility, and safety of the spacer. Two adult beagle dogs were used in this study. Video-assisted thoracoscopic surgery (VATS) was performed through two ports to insert the spacer between the lung and mediastinum of the left thoracic cavity. CT examination was performed with the spacer inflated at 1 week and 2 weeks after insertion. Four weeks after insertion, the spacer was removed. We created two virtual tumors that presented a high risk of severe mediastinal organ toxicity from SBRT. Radiation treatment planning of SBRT was conducted in both cases, and the radiation dose for mediastinal organs was compared between the cases with and without the spacer.

      Result:
      The spacer could be safely inserted between the lung and mediastinum via the VATS procedure. The novel spacer provided a distance of 5-10 mm between the virtual tumor and the mediastinal organs. The reduced radiation dose for risk organs were calculated as 7.0-27.5% in the aorta, 3.0-12.3% in the esophagus, and 7-25% in the spine. The spacer did not adhere to the mediastinal organs, and was removed smoothly. Figure 1



      Conclusion:
      The novel mediastinal spacer may potentially reduce mediastinal organ toxicity from SBRT when treating centrally located lung tumors.

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