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Search indexed NASA NTRS and DOE OSTI research on propulsion, heat transfer, battery materials and energy systems. Follow report and document links to the original sources.

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At least 343 records · Page 19
All sourcesNASA NTRSDOE OSTI
DOE OSTI2013

Supratentorial Ependymoma: Disease Control, Complications, and Functional Outcomes After Irradiation

Purpose: Ependymoma is less commonly found in the supratentorial brain and has known clinical and molecular features that are unique. Our single-institution series provides valuable information about disease control for supratentorial ependymoma and the complications of supratentorial irradiation in children. Methods and Materials: A total of 50 children with newly diagnosed supratentorial ependymoma were treated with adjuvant radiation therapy (RT); conformal methods were used in 36 after 1996. The median age at RT was 6.5 years (range, 1-18.9 years). The entire group was characterized according to sex (girls 27), race (white 43), extent of resection (gross-total 46), and tumor grade (anaplastic 28). The conformal RT group was prospectively evaluated for neurologic, endocrine, and cognitive effects. Results: With a median follow-up time of 9.1 years from the start of RT for survivors (range, 0.2-23.2 years), the 10-year progression-free and overall survival were 73% + 7% and 76% + 6%, respectively. None of the evaluated factors was prognostic for disease control. Local and distant failures were evenly divided among the 16 patients who experienced progression. Eleven patients died of disease, and 1 of central nervous system necrosis. Seizure disorders were present in 17 patients, and 4 were considered to be clinically disabled. Clinically significant cognitive effects were limited to children with difficult-to-control seizures. The average values for intelligence quotient and academic achievement (reading, spelling, and math) were within the range of normal through 10 years of follow-up. Central hypothyroidism was the most commonly treated endocrinopathy. Conclusion: RT may be administered with acceptable risks for complications in children with supratentorial ependymoma. These results suggest that outcomes for these children are improving and that complications may be limited by use of focal irradiation methods.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2012

Pathophysiology and Natural History of Anorectal Sequelae Following Radiation Therapy for Carcinoma of the Prostate

Purpose: To characterize the prevalence, pathophysiology, and natural history of chronic radiation proctitis 5 years following radiation therapy (RT) for localized carcinoma of the prostate. Methods and Materials: Studies were performed in 34 patients (median age 68 years; range 54-79) previously randomly assigned to either 64 Gy in 32 fractions over 6.4 weeks or 55 Gy in 20 fractions over 4 weeks RT schedule using 2- and later 3-dimensional treatment technique for localized prostate carcinoma. Each patient underwent evaluations of (1) gastrointestinal (GI) symptoms (Modified Late Effects in Normal Tissues Subjective, Objective, Management and Analytic scales including effect on activities of daily living [ADLs]); (2) anorectal motor and sensory function (manometry and graded balloon distension); and (3) anal sphincteric morphology (endoanal ultrasound) before RT, at 1 month, and annually for 5 years after its completion. Results: Total GI symptom scores increased after RT and remained above baseline levels at 5 years and were associated with reductions in (1) basal anal pressures, (2) responses to squeeze and increased intra-abdominal pressure, (3) rectal compliance and (4) rectal volumes of sensory perception. Anal sphincter morphology was unchanged. At 5 years, 44% and 21% of patients reported urgency of defecation and rectal bleeding, respectively, and 48% impairment of ADLs. GI symptom scores and parameters of anorectal function and anal sphincter morphology did not differ between the 2 RT schedules or treatment techniques. Conclusions: Five years after RT for prostate carcinoma, anorectal symptoms continue to have a significant impact on ADLs of almost 50% of patients. These symptoms are associated with anorectal dysfunction independent of the RT schedules or treatment techniques reported here.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2026

A strong and ductile Super Kovar alloy via fully coherent nanoprecipitates

Emerging high-precision technologies demand materials with exceptional dimensional stability and mechanical robustness, as even microscopic thermomechanical deformation can cause functional failure. However, a fundamental trilemma exists: High strength, ductility, and low thermal expansion are mutually exclusive, as strengthening-induced lattice distortions compromise the spin-lattice coupling, which is essential for low thermal expansion. Here, we overcome this trilemma by designing “Super Kovar,” an Fe-Ni-Co-Al-Ta alloy, featuring fully coherent nanoprecipitates. It unifies a 1.0-gigapascal ultimate tensile strength and ∼39% elongation with a Kovar-grade thermal expansion of 3.81 × 10−6 K−1 (100 to 410 K). The key is a dense dispersion of L12 nanoprecipitates that form an almost strain-free coherent interface with the ferromagnetic matrix. Beyond providing precipitation strengthening, these coherent interfaces suppress intrinsic phonons of nanoprecipitates via elastic coupling while avoiding magnetic domain pinning to preserve the Invar effect of the matrix. This reduces the thermal expansion of the precipitates by 56% and achieves a fourfold enhancement in the strength-ductility product, establishing a paradigm for dimensionally stable, ultrastrong alloys.

Yu, Chengyi [University of Science and Technology ↗
NASA NTRS2004

Ultra-high Temperature Ceramic Composites for Leading Edges, 2004

Ultrahigh temperature ceramics (UHTC) have performed unreliably due to material flaws and attachment design. These deficiencies are brought to the fore by the low fracture toughness and thermal shock resistance of the UHTC. If these deficiencies are overcome, we are still faced with poor oxidation resistance as a limitation on UHTC applicability to reusable launch vehicles. We have been addressing the deficiencies of UHTC for the past two years via a small task at GRC that is in the Airframe part of the Next Generation Launch Technology Program. Our focus is on composite constructions and functional grading to address the mechanical issues and on composition modification to address the oxidation issue. The progress on approaches to improving oxidation resistance by alloying and functional grading will be reported.

Levine, Stanley R.↗
DOE OSTI2022

Comparative Effects of Radiation Sterilization Modality on Medical PVC Tubing

As the production volume of single-use, polymer-based medical devices increases each year, so does the need for throughput capacity to sterilize the devices. Around 80% of radiation-sterilized devices are processed using gamma-ray radiation from industrial cobalt-60 sources. Supply chain, security, and disposal concerns are prompting manufacturers and contract sterilizers to explore alternatives to irradiation using cobalt-60 gamma-rays, such as electron beam (E-beam) and X-ray radiation. Advantages of these ‘machine’ sources over radioisotope-based sources are that they do not decay, a characteristic that requires cobalt-60 to be replaced over time, they can be turned off when not in use, and they do not represent the same level of concern regarding misuse. One of the barriers to direct transition from gamma-ray sterilization to E-beam or X-ray sterilization is concern over the relatively unknown effects of sterilization dose of these alternative modalities on the performance of medical device polymers. Commercially available medical devices sterilized with gamma-ray irradiation exhibit acceptable device function, acceptable mechanical performance, and acceptable discoloration. To be viable, alternate sterilization methods must not only achieve acceptable sterilization, but the process must also result in a product with functional, mechanical, and visual effects acceptable to customers and the regulator. Flexible polyvinyl chloride (PVC) is a plastic material that is commonly found in single-use medical devices and is known for its sensitivity to radiation processing. For instance, transparent PVC is known to yellow upon irradiation. To encouraging sterilization alternatives to cobalt-60 gamma-ray, we directly compared the effects of gamma-ray, E-beam, and X-ray radiation exposure at similar sterilization-relevant doses on key properties of medical grade PVC tubing.

cobalt-60↗
DOE OSTI2017

Experimental Investigation of Gas/Slag/Matte/Tridymite Equilibria in the Cu-Fe-O-S-Si System in Controlled Gas Atmospheres: Experimental Results at 1473 K (1200 °C) and P(SO{sub 2}) = 0.25 atm

Experimental studies were undertaken to determine the gas/slag/matte/tridymite equilibria in the Cu-Fe-O-S-Si system at 1473 K (1200 °C), P(SO{sub 2}) = 0.25 atm, and a range of P(O{sub 2})’s. The experimental methodology involved high-temperature equilibration using a substrate support technique in controlled gas atmospheres (CO/CO{sub 2}/SO{sub 2}/Ar), rapid quenching of equilibrium phases, followed by direct measurement of the chemical compositions of the phases with Electron Probe X-ray Microanalysis (EPMA). The experimental data for slag and matte were presented as a function of copper concentration in matte (matte grade). The data provided are essential for the evaluation of the effect of oxygen potential under controlled atmosphere on the matte grade, liquidus composition of slag and chemically dissolved copper in slag. The new data provide important accurate and reliable quantitative foundation for improvement of the thermodynamic databases for copper-containing systems.

36 MATERIALS SCIENCE↗
DOE OSTI2024

Influence of printing parameters on the mechanical behavior of 3D-printed SS316L parts manufactured using laser hot wire directed energy deposition

Hybrid manufacturing combines the simultaneous benefits of additive manufacturing (complex geometries, part consolidation, and mass customization) with the advantages of subtractive manufacturing (superior surface finish and enhanced dimensional accuracies) by integrating a suite of complementary traditional processes into a base platform of additive manufacturing. The use of hybrid technology has grown in recent years given its capabilities on repairing metallic structures, producing parts with conformal cooling features, and manufacturing functionally graded products. These kinds of capabilities are of great interest to the medical implant, energy, automotive, maritime, and aerospace industry sectors, among many other fields. This work investigated the mechanical properties of stainless steel (SS) 316L as a function of different tool paths strategies using an integrated 5-axis CNC hybrid Mazak system with a laser hot wire deposition system (LHWDS). This study includes the evaluation of different printing parameters and their impact on the quality of the printed bead as well as the incorporation of a structure–property material relationship based on the mechanical performance of the manufactured coupons.

36 MATERIALS SCIENCE↗
DOE OSTI2023

Additive Manufacturing of Ultrahigh Temperature Refractory Metal Alloys

The project advances the manufacture of RMA for ultrahigh-temperature service with three main innovations: a thermodynamically derived high-throughput AM synthesis and characterization using reactive synthesis of elemental powders, a new dimensional number to predict processing parameters, and a novel processing scheme for the fabrication of components with functional grading microstructures. With these advances, the project demonstrates in Phase I the manufacture of RMAs exhibiting room temperature compression ductility above 20%, room temperature fracture toughness above 10 MPam 0.5 , and the fabrication of tensile test samples that have a transformative impact on the manufacturing of RMAs by enabling cost-efficient and large-scale fabrication of components.

33 ADVANCED PROPULSION SYSTEMS↗
DOE OSTI2024

Oak Ridge National Laboratory Thermoplastic Composite Joining of Pultruded Continuous Fiber Spars for Multi-Functional Battery Enclosure

Oak Ridge National Laboratory (ORNL) worked with DowAksa Industry to investigate the potential of using PA66 material to produce larger composite parts, transcending the limitations of traditional presses. The project aimed to develop a suitable material for printing battery boxes using Nylon 66 infused with 40 wt.% carbon fiber, compatible with the ORNL Additive Manufacturing and Compression Molding (AM-CM) system. However, even with extensive work, it was concluded that the material is not compatible with the AMCM process and suitable for joining using compression technique. Main reason for the incompatibility were found to be very high crystallinity of the PA66 grade chosen for this work. To improve printability, a modifier (proprietary) was added to decrease crystallinity, but this led to reduced thermal stability and adhesion issues.

36 MATERIALS SCIENCE↗
DOE OSTI2011

Patterns of Response After Preoperative Intensity-Modulated Radiation Therapy and Capecitabine/Oxaliplatin in Rectal Cancer: Is There Still a Place for Ecoendoscopic Ultrasound?

Purpose: The main goals of preoperative chemoradiotherapy (CHRT) in rectal cancer are to achieve pathological response and to ensure tumor control with functional surgery when possible. Assessment of the concordance between clinical and pathological responses is necessary to make decisions regarding alternative conservative procedures. The present study evaluates the patterns of response after a preoperative CHRT regimen, and the value of endoscopic ultrasound (EUS) in assessing response. Methods and Materials: A total of 51 EUS-staged T3 to T4 and/or N0 to N+ rectal cancer patients received preoperative CHRT (intensity-modulated radiation therapy and capecitabine/oxaliplatin (XELOX) followed by radical resection. Clinical response was assesed by EUS. Rates of pathological tumor regression grade (TRG) and lymph node (LN) involvement were determined in the surgical specimen. Clinical and pathological responses were compared, and the accuracy of EUS in assessing response was calculated. Results: Twenty-four patients (45%) achieved a major pathological response (complete or >95% pathological response (TRG 3+/4)). Sensitivity, specificity, negative predictive value, and positive predictive value of EUS in predicting pathological T response after preoperative CHRT were 77.8%, 37.5%, 60%, and 58%, respectively. The EUS sensitivity, specificity, negative predictive value, and positive predictive value for nodal staging were 44%, 88%, 88%, and 44%, respectively. Furthermore, EUS after CHRT accurately predicted the absence of LN involvement in 7 of 7 patients (100%) with major pathological response of the primary tumor. Conclusion: Preoperative IMRT with concomitant XELOX induces favorable rates of major pathological response. EUS has a limited ability to predict primary tumor response after preoperative CHRT, but it is useful for accurately determining LN status. EUS may have a potential value in identifying patients with a very low risk of LN involvement in association with a good pathological response as potential candidates for conservative local surgical protocols.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2013

ATM Polymorphisms Predict Severe Radiation Pneumonitis in Patients With Non-Small Cell Lung Cancer Treated With Definitive Radiation Therapy

Purpose: The ataxia telangiectasia mutated (ATM) gene mediates detection and repair of DNA damage. We investigated associations between ATM polymorphisms and severe radiation-induced pneumonitis (RP). Methods and Materials: We genotyped 3 potentially functional single nucleotide polymorphisms (SNPs) of ATM (rs1801516 [D1853N/5557G>A], rs189037 [-111G>A] and rs228590) in 362 patients with non-small cell lung cancer (NSCLC), who received definitive (chemo)radiation therapy. The cumulative severe RP probabilities by genotypes were evaluated using the Kaplan-Meier analysis. The associations between severe RP risk and genotypes were assessed by both logistic regression analysis and Cox proportional hazard model with time to event considered. Results: Of 362 patients (72.4% of non-Hispanic whites), 56 (15.5%) experienced grade ≥3 RP. Patients carrying ATM rs189037 AG/GG or rs228590 TT/CT genotypes or rs189037G/rs228590T/rs1801516G (G-T-G) haplotype had a lower risk of severe RP (rs189037: GG/AG vs AA, adjusted hazard ratio [HR] = 0.49, 95% confidence interval [CI], 0.29-0.83, P=.009; rs228590: TT/CT vs CC, HR=0.57, 95% CI, 0.33-0.97, P=.036; haplotype: G-T-G vs A-C-G, HR=0.52, 95% CI, 0.35-0.79, P=.002). Such positive findings remained in non-Hispanic whites. Conclusions: ATM polymorphisms may serve as biomarkers for susceptibility to severe RP in non-Hispanic whites. Large prospective studies are required to confirm our findings.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
NASA NTRS2020

Effects of Texture and Silica Content on Crack Growth in Boron Nitrides

Boron nitride is used in applications such as crucibles for melting and casting glasses and metals, insulators for furnaces, molds for hot pressing, and neutron absorbers. Historically, various grades of hot pressed hexagonal boron nitride (BN) have been used. This study investigates the fracture toughness and slow crack growth parameters of several commercially available BN grades. Prior work revealed that some grades of BN absorb water and change strength, thus presenting a philosophical conundrum on crack growth test methods. The grades selected for this study are of interest because their available billet size is sufficient for large components, or because they have heritage in specific applications. Ultimately, the data will be used to perform material selection, system design and reliability analyses of components of interest. Boron nitrides exhibit limited slow crack growth in humidity, with an orientation dependence due to crystallographic texture: orientations with van der Waal bonds are insensitive to water whereas those with covalent bonds are sensitive. Fracture toughness is low, around that of glass, and is also a function of orientation (bond type), with fracture occurring more readily along van der Waal bonds between hexagonal BN platelets than at covalent bonds across platelets. Silica additions toughen BN, but increase slow crack growth susceptibility.

Salem, Jonathan A.↗
DOE OSTI2024

High-temperature structure, elasticity, and thermal expansion of ε-ZrH 1.8

Zirconium hydride is a promising candidate material for nuclear microreactor applications as a solid-state moderator component, owing to its favorable neutronics properties and good thermal stability over other metal hydrides. Here, in the present work, the crystal structure, thermal expansion, and elastic properties of the hydrogen-rich ε phase hydride were measured at elevated temperatures in the range 300–900 K. Samples were prepared by direct hydriding Zircaloy-4 metal – a nuclear-grade zirconium alloy. Room-temperature lattice parameters agree well with those reported from literature for unalloyed zirconium hydride and fall within an observed quadratic H-content dependence. The coefficients of thermal expansion, determined from lattice expansion and dilatometry, agree well within our work but were about 30 % lower than those reported by others for unalloyed hydrides. Density functional theory-based molecular dynamics simulations were used to compare with thermal expansion and elasticity measurements. Results showed lattice parameter temperature dependence and slope of thermal expansion align with those from measurements. Based on diffraction scans at select temperatures, ε phase remained stable in air up to at least 770 K. Likewise, dilatometry showed smooth thermal expansion up to the thermal decomposition temperature around 950 K. The precise decomposition temperature was not determined via diffraction due to sparse scanning. The complete elastic property measurements were gathered for ε-phase Ziracloy-4 hydride for the first time. Young's modulus was lower compared to the metal and δ hydride phases. High-temperature elasticity measurements were limited to <350 K due to acoustic dissipation effects.

36 MATERIALS SCIENCE↗
DOE OSTI2010

Dose-Escalation Study of Single-Fraction Stereotactic Body Radiotherapy for Liver Malignancies

Purpose: We performed a Phase I dose-escalation study to explore the feasibility and safety of treating primary and metastatic liver tumors with single-fraction stereotactic body radiotherapy (SBRT). Methods and Materials: Between February 2004 and February 2008, 26 patients were treated for 40 identifiable lesions. Nineteen patients had hepatic metastases, 5 had intrahepatic cholangiocarcinomas, and 2 had recurrent hepatocellular carcinomas. The prescribed radiation dose was escalated from 18 to 30 Gy at 4-Gy increments with a planned maximum dose of 30 Gy. Cumulative incidence functions accounted for competing risks to estimate local failure (LF) incidence over time under the competing risk of death. Results: All patients tolerated the single-fraction SBRT well without developing a dose-limiting toxicity. Nine acute Grade 1 toxicities, one acute Grade 2 toxicity, and two late Grade 2 gastrointestinal toxicities were observed. After a median of 17 months follow-up (range, 2-55 months), the cumulative risk of LF at 12 months was 23%. Fifteen patients have died: 11 treated for liver metastases and 4 with primary liver tumors died. The median survival was 28.6 months, and the 2-year actuarial overall survival was 50.4%. Conclusions: It is feasible and safe to deliver single-fraction, high-dose SBRT to primary or metastatic liver malignancies measuring {<=}5 cm. Moreover, single-fraction SBRT for liver lesions demonstrated promising local tumor control with minimal acute and long-term toxicity. Single-fraction SBRT appears to be a viable nonsurgical option, but further studies are warranted to evaluate both control rates and impact on quality of life.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2014

No Clinically Significant Changes in Pulmonary Function Following Stereotactic Body Radiation Therapy for Early- Stage Peripheral Non-Small Cell Lung Cancer: An Analysis of RTOG 0236

Purpose: To investigate pulmonary function test (PFT) results and arterial blood gas changes (complete PFT) following stereotactic body radiation therapy (SBRT) and to see whether baseline PFT correlates with lung toxicity and overall survival in medically inoperable patients receiving SBRT for early stage, peripheral, non-small cell lung cancer (NSCLC). Methods and Materials: During the 2-year follow-up, PFT data were collected for patients with T1-T2N0M0 peripheral NSCLC who received effectively 18 Gy × 3 in a phase 2 North American multicenter study (Radiation Therapy Oncology Group [RTOG] protocol 0236). Pulmonary toxicity was graded by using the RTOG SBRT pulmonary toxicity scale. Paired Wilcoxon signed rank test, logistic regression model, and Kaplan-Meier method were used for statistical analysis. Results: At 2 years, mean percentage predicted forced expiratory volume in the first second and diffusing capacity for carbon monoxide declines were 5.8% and 6.3%, respectively, with minimal changes in arterial blood gases and no significant decline in oxygen saturation. Baseline PFT was not predictive of any pulmonary toxicity following SBRT. Whole-lung V5 (the percentage of normal lung tissue receiving 5 Gy), V10, V20, and mean dose to the whole lung were almost identical between patients who developed pneumonitis and patients who were pneumonitis-free. Poor baseline PFT did not predict decreased overall survival. Patients with poor baseline PFT as the reason for medical inoperability had higher median and overall survival rates than patients with normal baseline PFT values but with cardiac morbidity. Conclusions: Poor baseline PFT did not appear to predict pulmonary toxicity or decreased overall survival after SBRT in this medically inoperable population. Poor baseline PFT alone should not be used to exclude patients with early stage lung cancer from treatment with SBRT.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2016

Use of the drift-time method to measure the electron lifetime in long-drift-length CdZnTe detectors

The traditional method for electron lifetime measurements of CdZnTe (CZT) detectors relies on using the Hecht equation. The procedure involves measuring the dependence of the detector response on the applied bias to evaluate the μτ product, which in turn can be converted into the carrier lifetime. Despite general acceptance of this technique, which is very convenient for comparative testing of different CZT materials, the assumption of a constant electric field inside a detector is unjustified. In the Hecht equation, this assumption means that the drift time would be a linear function of the distance. This condition is not fulfilled in practice at low applied biases, where the Hecht equation is most sensitive to the μτ product. As a result, researchers usually take measurements at relatively high biases, which work well in the case of the low μτ-product material, <10 -3 cm 2 /V, but give significantly underestimated values for the case of high μτ-product crystals. In this paper, we applied the drift-time method to measure the electron lifetimes in long-drift-length (4 cm) standard-grade CZT detectors produced by the Redlen Technologies. We found that the electron μτ product of tested crystals is in the range 0.1–0.2 cm 2 /V, which is an order of the magnitude higher than any value previously reported for a CZT material. Finally, in comparison, using the Hecht equation fitting, we obtained μτ = 2.3 × 10 -2 cm 2 /V for a 2-mm thin planar detector fabricated from the same CZT material.

47 OTHER INSTRUMENTATION↗
DOE OSTI2013

Predicting Pneumonitis Risk: A Dosimetric Alternative to Mean Lung Dose

Purpose: To determine whether the association between mean lung dose (MLD) and risk of severe (grade {>=}3) radiation pneumonitis (RP) depends on the dose distribution pattern to normal lung among patients receiving 3-dimensional conformal radiation therapy for non-small-cell lung cancer. Methods and Materials: Three cohorts treated with different beam arrangements were identified. One cohort (2-field boost [2FB]) received 2 parallel-opposed (anteroposterior-posteroanterior) fields per fraction initially, followed by a sequential boost delivered using 2 oblique beams. The other 2 cohorts received 3 or 4 straight fields (3FS and 4FS, respectively), ie, all fields were irradiated every day. The incidence of severe RP was plotted against MLD in each cohort, and data were analyzed using the Lyman-Kutcher-Burman (LKB) model. Results: The incidence of grade {>=}3 RP rose more steeply as a function of MLD in the 2FB cohort (N=120) than in the 4FS cohort (N=138), with an intermediate slope for the 3FS group (N=99). The estimated volume parameter from the LKB model was n=0.41 (95% confidence interval, 0.15-1.0) and led to a significant improvement in fit (P=.05) compared to a fit with volume parameter fixed at n=1 (the MLD model). Unlike the MLD model, the LKB model with n=0.41 provided a consistent description of the risk of severe RP in all three cohorts (2FB, 3FS, 4FS) simultaneously. Conclusions: When predicting risk of grade {>=}3 RP, the mean lung dose does not adequately take into account the effects of high doses. Instead, the effective dose, computed from the LKB model using volume parameter n=0.41, may provide a better dosimetric parameter for predicting RP risk. If confirmed, these findings support the conclusion that for the same MLD, high doses to small lung volumes ('a lot to a little') are worse than low doses to large volumes ('a little to a lot').

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2015

Toxicity After Central versus Peripheral Lung Stereotactic Body Radiation Therapy: A Propensity Score Matched-Pair Analysis

Purpose: To compare toxicity after stereotactic body radiation therapy (SBRT) for “central” tumors—within 2 cm of the proximal bronchial tree or with planning tumor volume (PTV) touching mediastinum—versus noncentral (“peripheral”) lung tumors. Methods and Materials: From November 2005 to January 2011, 229 tumors (110 central, 119 peripheral; T1-3N0M0 non–small-cell lung cancer and limited lung metastases) in 196 consecutive patients followed prospectively at a single institution received moderate-dose SBRT (48-60 Gy in 4-5 fractions [biologic effective dose=100-132 Gy, α/β=10]) using 4-dimensional planning, online image-guided radiation therapy, and institutional dose constraints. Clinical adverse events (AEs) were graded prospectively at clinical and radiographic follow-up using Common Terminology Criteria for Adverse Events version 3.0. Pulmonary function test (PFT) decline was graded as 2 (25%-49.9% decline), 3 (50.0%-74.9% decline), or 4 (≥75.0% decline). Central/peripheral location was assessed retrospectively on planning CT scans. Groups were compared after propensity score matching. Characteristics were compared with χ{sup 2} and 2-tailed t tests, adverse events with χ{sup 2} test-for-trend, and cumulative incidence using competing risks analysis (Gray's test). Results: With 79 central and 79 peripheral tumors matched, no differences in AEs were observed after 17 months median follow-up. Two-year cumulative incidences of grade ≥2 pain, musculoskeletal, pulmonary, and skin AEs were 14%, 5%, 6%, and 10% (central) versus 19%, 10%, 10%, and 3% (peripheral), respectively (P=.31, .38, .70, and .09). Grade ≥2 cardiovascular, gastrointestinal, and central nervous system AEs were rare (<1%). Two-year incidences of grade ≥2 clinical AEs (28% vs 25%, P=.79), grade ≥2 PFT decline (36% vs 34%, P=.94), grade ≥3 clinical AEs (3% vs 7%, P=.48), and grade ≥3 PFT decline (0 vs 10%, P=.11) were similar for central versus peripheral tumors, respectively. Pooled 2-year incidences of grades 4 and 5 AEs were <1% and 0%, respectively, in both the prematched and matched groups. Conclusion: Moderate-dose SBRT with these techniques yields a similarly safe toxicity profile for both central and peripheral lung tumors.

62 RADIOLOGY AND NUCLEAR MEDICINE↗