Re-Irradiation of Locoregional NSCLC Recurrence Using Robotic Stereotactic Body Radiotherapy

Oncol Res Treat. 2017;40(4):207-214. doi: 10.1159/000457129. Epub 2017 Mar 9.

Abstract

Background: We evaluated the efficacy, toxicity, and dose responses of re-irradiation with stereotactic body radiotherapy (SBRT) in patients with recurrent non- small cell lung cancer (NSCLC) after previous irradiation.

Patients and methods: 28 patients were included. Previous median radiation doses were 54 and 66 Gy. The median interval time between previous radiotherapy and SBRT was 14 months. The median follow-up time after SBRT was 9 months (range 3-93 months). To evaluate the effectiveness of SBRT, local control, overall survival, and treatment-related toxicity were reported.

Results: SBRT doses and fractionation ranged from 60 to 30 Gy and from 3 to 8, respectively, according to previous doses, location of the recurrence, and interval time. 65% of tumor recurrences overlapped with previous treatment, while 35% of tumors recurred outside of the previous treatment. 4 patients had local progression after SBRT at their first follow-up. The Kaplan-Meier estimates of the 1- and 2-year actuarial overall survival were 71 and 42%, respectively. The mean survival following SBRT was 32.8 months, and the median survival was 21 months. No grade 3 or higher toxicities were observed.

Conclusion: Robotic SBRT is a tolerable treatment option with manageable toxicity which can be used with radical or palliative intent in carefully selected patients with locally recurrent tumors after previous irradiation.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Carcinoma, Non-Small-Cell Lung / mortality*
  • Carcinoma, Non-Small-Cell Lung / radiotherapy*
  • Dose-Response Relationship, Radiation
  • Female
  • Humans
  • Lung Neoplasms / mortality*
  • Lung Neoplasms / radiotherapy*
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / mortality*
  • Neoplasm Recurrence, Local / radiotherapy*
  • Prevalence
  • Radiation Injuries
  • Radiosurgery / mortality*
  • Radiosurgery / statistics & numerical data
  • Radiotherapy Dosage
  • Radiotherapy, Computer-Assisted / mortality
  • Radiotherapy, Computer-Assisted / statistics & numerical data
  • Re-Irradiation / mortality
  • Re-Irradiation / statistics & numerical data
  • Retrospective Studies
  • Risk Factors
  • Robotics / statistics & numerical data
  • Survival Rate
  • Treatment Outcome
  • Turkey / epidemiology