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Open Access 01-03-2015 | Original Research

Stereotactic body radiotherapy for re-irradiation of lung cancer recurrence with lower biological effective doses

Authors: Nisha R. Patel, Rachelle Lanciano, Karna Sura, Jun Yang, John Lamond, Jing Feng, Michael Good, Ed J. Gracely, Lydia Komarnicky, Luther Brady

Published in: Journal of Radiation Oncology | Issue 1/2015

Abstract

Objective

Few studies have evaluated re-irradiation of lung cancer recurrences with stereotactic body radiotherapy (SBRT). This study evaluates outcomes with SBRT re-irradiation for recurrent lung cancer.

Methods

Two hundred and seventy-eight patients treated with SBRT for lung cancer were retrospectively reviewed. Of those, 26 patients with 29 tumors were re-irradiated with SBRT. Ninety percent of tumors received prior external beam irradiation and 10 % received prior SBRT. Previous median radiation dose was 61.2 Gy with a median 8-month interval from previous radiation. The median re-irradiation SBRT dose was 30 Gy (48 Gy₁₀ biological effective dose (BED)). Endpoints evaluated included local control, overall survival, and progression-free survival.

Results

Twenty-five of 29 tumors were evaluable for local control, with 27 tumors (93 %) considered in-field recurrences. In-field crude local control rate was 80 % (20/25) with 1 and 2-year actuarial rates of 78.6 and 65.5 %, respectively. One and 2-year actuarial survival rates were 52.3 and 37.0 %, respectively. One and 2-year actuarial progression-free survival rates were 56.7 and 37.0 %, respectively. Fifty-five percent of patients reported acute/chronic grades 1 and 2 toxicities. No grade 3 or higher toxicities were reported.

Conclusion

Patients with recurrent lung cancer have limited options. SBRT re-irradiation is tolerable even after a median 61.2 Gy to the re-irradiation site. The lower BED used provided acceptable progression-free survival with low toxicity. Given the poor prognosis with current treatment options, new paradigms for re-treatment should include SBRT-re-irradiation as an adjunct to systemic therapy for in-field lung cancer recurrence.

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Title: Stereotactic body radiotherapy for re-irradiation of lung cancer recurrence with lower biological effective doses
Authors: Nisha R. Patel
Rachelle Lanciano
Karna Sura
Jun Yang
John Lamond
Jing Feng
Michael Good
Ed J. Gracely
Lydia Komarnicky
Luther Brady
Publication date: 01-03-2015
Publisher: Springer Berlin Heidelberg
Published in: Journal of Radiation Oncology / Issue 1/2015
Print ISSN: 1948-7894
Electronic ISSN: 1948-7908
DOI: https://doi.org/10.1007/s13566-014-0175-2

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