Lung-cancer related chest events detected by periodical follow-up CT after stereotactic body radiotherapy for stage I primary lung cancer: retrospective analysis of incidence of lung-cancer related chest events and outcomes of salvage treatment

Jpn J Radiol. 2012 Oct;30(8):671-5. doi: 10.1007/s11604-012-0107-2. Epub 2012 Jul 20.

Abstract

Purpose: Follow-up by chest CT is often performed routinely after stereotactic body radiotherapy (SBRT) for primary lung cancer. We investigated how often periodical chest CT detected lung-cancer related chest events (failure in the chest, new primary lung cancer), and how often chest CT follow-ups led to curative intent salvage treatment.

Materials and methods: Between 2006 and 2009, 90 stage I primary lung cancers in 86 patients received SBRT. In principle, chest CT was scheduled every 2-3 months in the first two years, and every 3-4 months thereafter.

Results: Median time to follow-up by chest CT was 26 months (1-61 months). Twenty-seven lung-cancer related chest events were detected by periodical chest CT after SBRT. The three-year lung-cancer related chest event free rate was 62 %. It was possible to apply curative-intent salvage treatment to 56 % of the lung-cancer related chest events. The two-year overall survival rate was 66 % among the 13 patients who received curative-intent salvage treatment (radiotherapy, 11; surgery, 2).

Conclusion: Post-SBRT lung-cancer related chest events (as detected by periodical chest CT) were not uncommon (approximately 40 % at 3 years from SBRT), and it was possible to treat more than half of these lesions with curative-intent salvage treatment.

MeSH terms

  • Adenocarcinoma / diagnostic imaging*
  • Adenocarcinoma / mortality
  • Adenocarcinoma / pathology*
  • Adenocarcinoma / radiotherapy
  • Adenocarcinoma / therapy
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / diagnostic imaging*
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / pathology*
  • Carcinoma, Squamous Cell / radiotherapy
  • Carcinoma, Squamous Cell / therapy
  • Disease-Free Survival
  • Female
  • Fluorodeoxyglucose F18 / pharmacology
  • Follow-Up Studies
  • Humans
  • Incidence
  • Japan / epidemiology
  • Lung Neoplasms / diagnostic imaging*
  • Lung Neoplasms / mortality
  • Lung Neoplasms / pathology*
  • Lung Neoplasms / radiotherapy
  • Lung Neoplasms / therapy
  • Male
  • Middle Aged
  • Multimodal Imaging
  • Neoplasm Staging
  • Positron-Emission Tomography
  • Radiopharmaceuticals
  • Radiosurgery*
  • Retrospective Studies
  • Salvage Therapy
  • Survival Rate
  • Tomography, X-Ray Computed*
  • Treatment Outcome

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18