Clinical outcomes and toxicity predictors of thoracic re-irradiation for locoregionally recurrent lung cancer
Journal
Clinical and Translational Radiation Oncology
Journal Volume
22
Pages
76-82
Date Issued
2020
Abstract
Background and purpose: Thoracic re-irradiation may be an alternative treatment for lung cancer patients who develop intrathoracic locoregional recurrence without systemic progression. This study aimed to retrospectively assess locoregional control, clinical outcomes, and toxicities in lung cancer patients who received thoracic re-irradiation. Materials and methods: We retrospectively reviewed 50 lung cancer patients who received thoracic re-irradiation using conventional photon radiotherapy (RT) and stereotactic body radiotherapy (SBRT) between 2009 and 2017. The correlations of clinicopathologic factors, treatment factors, and dosimetric factors of RT with time to local progression (TTLP), progression-free survival (PFS), and overall survival (OS) after starting thoracic re-irradiation were calculated using log-rank tests and Cox regression models. Results: The median re-irradiation dose in equivalent dose in 2-Gy fractions was 51.1 Gy, and the mean re-irradiation planning target volume was 201.58 ml. The median mean lung dose (MLD) was 4.18 Gy, and the total lung volumes receiving a dose of 5 Gy (lung V5) and of 20 Gy (V20) were 19.8% and 5.85%, respectively. The TTLP, PFS, and OS were 18.0, 5.9, and 25.1 months, respectively. Lung V5 (p < 0.001), V20 (p = 0.011), and MLD (p = 0.002) were significantly associated with grade ?2 lung toxicity. Seven (14%) patients developed lethal lung events. Subsequent chemotherapy following thoracic re-irradiation was significantly correlated with lethal lung events (p = 0.009). Conclusion: Promising local control can be achieved with thoracic re-irradiation in lung cancer patients with locoregional recurrence. However, unexpected lethal lung events may occur, especially in patients receiving systemic therapy following thoracic re-irradiation. ? 2020 The Authors
SDGs
Other Subjects
aged; Article; cancer chemotherapy; cancer control; cancer growth; cancer radiotherapy; clinical article; clinical outcome; female; human; lung toxicity; male; non small cell lung cancer; overall survival; photon therapy; planning target volume; pneumonia; progression free survival; radiation dose; radiation dose distribution; radiation response; re-irradiation; retrospective study; small cell lung cancer; stereotactic body radiation therapy; total lung capacity
Publisher
Elsevier Ireland Ltd
Type
journal article