Under pressure.

There are three main ways people try to reduce lung tumor motion during SBRT. Abdominal compression is most commonly used (~50%) while another ⅓ use gating and 10-15% use breath hold gating. But could there be differences in local control with each technique? Cleveland Clinic has used both abdominal compression and breath-hold for lung SBRT since 2003. In this retrospective review, over 900 lesions were treated and most (~90%) were primary lung tumors and the most common dose regimen was 50 Gy in 5 fractions. The vast majority of patients (90%) were treated with abdominal compression and the rest with gating and breath-hold. The rate of local failure for the entire cohort was ~10%, and there was no significant difference in local failure when comparing motion management techniques nor was motion management technique associated with local failure in multivariable analysis. There was a suggestion, though, that central tumors may have had an increased risk of local failure with breath hold vs. compression. TBL: Respiratory motion management technique does not appear to impact local control with lung SBRT. | Gandhidasan, Pract Radiat Oncol 2020