Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
Radiation Oncology
Published in: Radiation Oncology 1/2018

Open Access 01-12-2018 | Research

Repeat stereotactic body radiotherapy (SBRT) for local recurrence of non-small cell lung cancer and lung metastasis after first SBRT

Authors: Yasutaka Ogawa, Yuta Shibamoto, Chisa Hashizume, Takuhito Kondo, Hiromitsu Iwata, Natsuo Tomita, Hiroyuki Ogino

Published in: Radiation Oncology | Issue 1/2018

Login to get access

Abstract

Background

This study evaluated the safety and efficacy of repeat SBRT for local recurrence of stage I non-small-cell lung cancer (NSCLC) and solitary lung metastasis.

Methods

Thirty-one patients with in-field local relapse of NSCLC (n = 23) or lung metastasis (n = 8) underwent repeat SBRT. All patients had grade 2 or lower radiation pneumonitis after the first SBRT. Local recurrence was diagnosed with CT and FDG-PET in 17 patients and by biopsy in 14. The median interval between the first and second SBRT was 18 months (range, 4–80). The first SBRT dose was mainly 48–52 Gy in 4 fractions (n = 25) according to the institutional protocols. Second SBRT doses were determined based on the tumor size and distance to organs at risk, and were mostly 48–52 Gy in 4 fractions (n = 13) or 60 Gy in 8 fractions (n = 13).

Results

At 3 years, overall survival and local control rates were 36 and 53%, respectively, for all 31 patients. Four patients showed no further recurrence for > 5 years (63–111 months) after the second SBRT. Radiation pneumonitis after the second SBRT was grade 2 in 4 patients, and no grade 3 pneumonitis was observed.

Conclusion

Repeat SBRT was safe. Local control and survival rates were higher than expected. SBRT should be an important treatment option for local recurrence of NSCLC or lung metastasis after previous local SBRT.

Trial registration

This retrospective study was approved by the ethics committee of our institution (September, 2017; approval number: 27–10).
Literature
1.
Kestin L, Grills I, Guckenberger M, Belderbos J, Hope AJ, Werner-Wasik M, et al. Dose-response relationship with clinical outcome for lung stereotactic body radiotherapy (SBRT) delivered via online image guidance. Radiother Oncol. 2014;110(3):499–504.CrossRefPubMed
2.
Bi N, Shedden K, Zheng X, Kong FS. Comparison of the effectiveness of radiofrequency ablation with stereotactic body radiation therapy in inoperable stage I non-small cell lung cancer: a systemic review and pooled analysis. Int J Radiat Oncol Biol Phys. 2016;95(5):1378–90.CrossRefPubMed
3.
Shibamoto Y, Hashizume C, Baba F, Ayakawa S, Miyakawa A, Murai T, et al. Stereotactic body radiotherapy using a radiobiology-based regimen for stage I non-small-cell lung cancer: five-year mature results. J Thorac Oncol. 2015;10(6):960–4.CrossRefPubMed
4.
Miyakawa A, Shibamoto Y, Baba F, Manabe Y, Murai T, Sugie C, et al. Stereotactic body radiotherapy for stage I non-small-cell lung cancer using higher doses for larger tumors: results of the second study. Radiat Oncol. 2017;12(1):152.CrossRefPubMedPubMedCentral
5.
Chang JY, Senan S, Paul MA, Mehran RJ, Louie AV, Balter P, et al. Stereotactic ablative radiotherapy versus lobectomy for operable stage I non-small-cell lung cancer: a pooled analysis of two randomised trials. Lancet Oncol. 2015;16(6):630–7.CrossRefPubMedPubMedCentral
6.
Robbins ME, Bywaters T, Rezvani M, Golding SJ, Hopewell JW. Residual radiation-induced damage to the kidney of the pig as assayed by retreatment. Int J Radiat Biol. 1991;60(6):917–28.CrossRefPubMed
7.
Stewart FA, Oussoren Y, Luts A. Long-term recovery and reirradiation tolerance of mouse bladder. Int J Radiat Oncol Biol Phys. 1990;18(6):1399–406.CrossRefPubMed
8.
Murray LJ, Lilley J, Hawkins MA, Henry AM, Dickinson P, Sebag-Montefiore D. Pelvic re-irradiation using stereotactic ablative radiotherapy (SABR): a systematic review. Radiother Oncol. 2017;125(2):213–22.CrossRefPubMed
9.
Kim YS. Reirradiation of head and neck cancer in the era of intensity-modulated radiotherapy: patient selection, practical aspects, and current evidence. Radiat Oncol J. 2017;35(1):1–15.CrossRefPubMedPubMedCentral
10.
Shibamoto Y, Yamashita J, Takahashi M, Abe M. Intraoperative radiation therapy for brain tumors with emphasis on retreatment for recurrence following full-dose external beam irradiation. Am J Clin Oncol. 1994;17(5):396–9.CrossRefPubMed
11.
Ang KK, Price RE, Stephens LC, Jiang GL, Feng Y, Schultheiss TE, et al. The tolerance of primate spinal cord to re-irradiation. Int J Radiat Oncol Biol Phys. 1993;25(3):459–64.CrossRefPubMed
12.
Nieder C, Milas L, Ang KK. Tissue tolerance to reirradiation. Semin Radiat Oncol. 2000;10(3):200–9.CrossRefPubMed
13.
Baba F, Shibamoto Y, Tomita N, Ikeya-Hashizume C, Oda K, Ayakawa S, et al. Stereotactic body radiotherapy for stage I lung cancer and small lung metastasis: evaluation of an immobilization system for suppression of respiratory tumor movement and preliminary results. Radiat Oncol. 2009;4:15.CrossRefPubMedPubMedCentral
14.
Shibamoto Y, Hashizume C, Baba F, Ayakawa S, Manabe Y, Nagai A, et al. Stereotactic body radiotherapy using a radiobiology-based regimen for stage I nonsmall cell lung cancer. A multicenter study. Cancer. 2012;118(8):2078–84.CrossRefPubMed
15.
Chaudhuri AA, Tang C, Binkley MS, Jin M, Wynne JF, von Eyben R, et al. Stereotactic ablative radiotherapy (SABR) for treatment of central and ultra-central lung tumors. Lung Cancer. 2015;89(1):50–6.CrossRefPubMed
16.
Hamaji M, Chen-Yoshikawa TF, Matsuo Y, Motoyama H, Hijiya K, Menju T, et al. Salvage video-assisted thoracoscopic lobectomy for isolated local relapse after stereotactic body radiotherapy for early stage non-small cell lung cancer: technical aspects and perioperative management. J Vis Surg. 2017;3:86.CrossRefPubMedPubMedCentral
17.
Verstegen NE, Maat APWM, Lagerwaard FJ, Paul MA, Versteegh MI, Joosten JJ, et al. Salvage surgery for local failures after stereotactic ablative radiotherapy for early stage non-small cell lung cancer. Radiat Oncol. 2016;11(1):131.CrossRefPubMedPubMedCentral
18.
Antonoff MB, Correa AM, Sepesi B, Nguyen QN, Walsh GL, Swisher SG, et al. Salvage pulmonary resection after stereotactic body radiotherapy: a feasible and safe option for local failure in selected patients. J Thorac Cardiovasc Surg. 2017;154(2):689–99.CrossRefPubMed
19.
Peulen H, Karlsson K, Lindberg K, Tullgren O, Baumann P, Lax I, et al. Toxicity after reirradiation of pulmonary tumours with stereotactic body radiotherapy. Radiother Oncol. 2011;101(2):260–6.CrossRefPubMed
20.
Patel NR, Lanciano R, Sura K, Yang J, Lamond J, Feng J, et al. Stereotactic body radiotherapy for re-irradiation of lung cancer recurrence with lower biological effective doses. J Radiat Oncol. 2015;4(1):65–70.CrossRefPubMed
21.
Valakh V, Miyamoto C, Micaily B, Chan P, Neicu T, Li S. Repeat stereotactic body radiation therapy for patients with pulmonary malignancies who had previously received SBRT to the same or an adjacent tumor site. J Cancer Res Ther. 2013;9(4):680.CrossRefPubMed
22.
Kilburn JM, Kuremsky JG, Blackstock AW, Munley MT, Kearns WT, Hinson WH, et al. Thoracic re-irradiation using stereotactic body radiotherapy (SBRT) techniques as first or second course of treatment. Radiother Oncol. 2014;110(3):505–10.CrossRefPubMedPubMedCentral
23.
Meijneke TR, Petit SF, Wentzler D, Hoogeman M, Nuyttens JJ. Reirradiation and stereotactic radiotherapy for tumors in the lung: dose summation and toxicity. Radiother Oncol. 2013;107(3):423–7.CrossRefPubMed
24.
Ester EC, Jones DA, Vernon MR, Yuan J, Weaver RD, Shanley RM, et al. Lung reirradiation with stereotactic body radiotherapy (SBRT). J Radiosurg SBRT. 2013;2(4):325–31.PubMedPubMedCentral
25.
Nishimura S, Takeda A, Sanuki N, Yoshida S, Shigematsu N. Dose-escalated stereotactic body radiotherapy (SBRT) as a salvage treatment for two cases with relapsed peripheral lung cancer after initial SBRT. J Thorac Oncol. 2015;10(8):e69–71.CrossRefPubMed
26.
Trakul N, Harris JP, Le Q-T, Hara WY, Maxim PG, Loo BW Jr, et al. Stereotactic ablative radiotherapy for reirradiation of locally recurrent lung tumors. J Thorac Oncol. 2012;7(9):1462–5.CrossRefPubMed
27.
Hearn JWD, Videtic GMM, Djemil T, Stephans KL. Salvage stereotactic body radiation therapy (SBRT) for local failure after primary lung SBRT. Int J Radiat Oncol Biol Phys. 2014;90(2):402–6.CrossRefPubMed
28.
Caivano D, Valeriani M, De Matteis S, Bonome P, Russo I, De Sanctis V, et al. Re-irradiation in lung disease by SBRT: a retrospective, single institutional study. Radiat Oncol. 2018;13:87.CrossRefPubMedPubMedCentral
29.
Nonaka H, Onishi H, Ozaki M, Kuriyama K, Komiyama T, Saito R. Serious gastric perforation after second stereotactic body radiotherapy for peripheral lung cancer that recurred after initial stereotactic body radiotherapy: a case report. J Med Case Rep. 2017;11(1):342.CrossRef
30.
van Rotterdam A, Barendsen GW, Gaiser JF. Radiosensitivity of cells in recurrent experimental tumours and the effectiveness of tumour retreatment. Radiother Oncol. 1987;8(2):171–6.CrossRefPubMed
31.
Ando K, Koike S, Shikita M, Hayata I, Otsu H, Satoh S. Radiosensitivity of late recurrences following radiotherapy of murine fibrosarcomas. Radiat Res. 1988;113(2):334–45.CrossRefPubMed
32.
Takeda T, Takeda A, Kunieda E, Ishizaka A, Takemasa K, Shimada K, et al. Radiation injury after hypofractionated stereotactic radiotherapy for peripheral small lung tumors: serial changes on CT. Am J Roentgenol. 2004;182(5):1123–8.CrossRef
33.
Takenaka R, Shibamoto Y, Miyakawa A, Hashizume C, Baba F. The fate of residual tumor masses that persist after stereotactic body radiotherapy for solitary lung nodules: will they recur? Clin Lung Cancer. 2016;17(5):406–11.CrossRefPubMed
Metadata
Title
Repeat stereotactic body radiotherapy (SBRT) for local recurrence of non-small cell lung cancer and lung metastasis after first SBRT
Authors
Yasutaka Ogawa
Yuta Shibamoto
Chisa Hashizume
Takuhito Kondo
Hiromitsu Iwata
Natsuo Tomita
Hiroyuki Ogino
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Radiation Oncology / Issue 1/2018
Electronic ISSN: 1748-717X
DOI
https://doi.org/10.1186/s13014-018-1080-4

Other articles of this Issue 1/2018

Radiation Oncology 1/2018 Go to the issue

Research

Hypoxia imaging with 18F-FAZA PET/CT predicts radiotherapy response in esophageal adenocarcinoma xenografts

Research

Light and shadows of a new technique: is photon total-skin irradiation using helical IMRT feasible, less complex and as toxic as the electrons one?

Research

Identifying risk factors for L’Hermitte’s sign after IMRT for head and neck cancer

Case report

Unresectable hepatic PEComa: a rare malignancy treated with stereotactic body radiation therapy (SBRT) followed by complete resection

Research

Assessment of the modulation degrees of intensity-modulated radiation therapy plans

Research

RNA-sequencing in non-small cell lung cancer shows gene downregulation of therapeutic targets in tumor tissue compared to non-malignant lung tissue