Cone‐beam computed tomography (CT)‐guided volumetric‐modulated arc therapy (VMAT) plans for stereotactic body radiotherapy (SBRT) treatment of synchronous multiple lung lesions with a flattening filter‐free (FFF) beam is a safe and highly effective treatment option for oligometastases lung cancer patients. Fourteen patients with metastatic non–small‐cell lung cancer (NSCLC) lesions (two to five) received a single‐isocenter VMAT SBRT treatment in our clinic. Four‐dimensional (4D) CT‐based treatment plans were generated using advanced AcurosXB‐based dose calculation algorithm using heterogeneity corrections with a single isocenter placed between/among the lesions. Compared to 10X‐FFF and traditional flattened 6X (6X‐FF) beams, 6X‐FFF beam produced highly conformal radiosurgical dose distribution to each target volume, reduced dose to adjacent organs at risk (OAR), and significantly reduced the lung SBRT fraction duration to < 3.5 min/fraction for 54/50 Gy treatments in 3/5 fractions — significantly improving patient convenience and clinic workflow. Early follow‐up CT imaging (mean, 9 months) results show high local control rates (100%) with no acute lung or rib toxicity. Longer clinical follow up in a larger patient cohort is ongoing to further validate the outcomes of this treatment approach.

中文翻译：

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关于使用单等中心VMAT计划对同步性多发性肺部病变进行SBRT治疗：计划质量，治疗效率和早期临床结果

锥束计算机断层扫描（CT）引导的容积调制弧光治疗（VMAT）计划，采用扁平无滤光片（FFF）束治疗同步性多发性肺部病变的立体定向放射治疗（SBRT），是一种安全有效的治疗方案适用于肺癌患者的低转移。在我们的诊所中，有14例转移性非小细胞肺癌（NSCLC）病变患者（二至五例）接受了单等中心VMAT SBRT治疗。使用先进的基于AcurosXB的剂量计算算法通过异质性校正（在病变之间/之间放置单个等中心点），生成基于CT的四维（4D）治疗计划。与10X-FFF和传统的扁平6X（6X-FF）光束相比，6X-FFF光束在每个目标体积上产生高度保形的放射外科剂量分布，对于54/50 Gy治疗，以3/5的比例降低了临近危险器官（OAR）的剂量，并将肺SBRT比例持续时间显着减少至<3.5分钟/部分，从而显着改善了患者的便利性和临床工作流程。CT早期随访（平均9个月）结果显示，局部控制率高（100％），无急性肺或肋骨毒性。正在进行更大范围患者队列的长期临床随访，以进一步验证这种治疗方法的结果。