open access

Vol 20, No 6 (2015)
Special Issue Papers
Published online: 2015-11-01
Submitted: 2015-01-07
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Local failure after primary radiotherapy in lung cancer: Is there a role for SBRT?

Beatriz E. Amendola, Marco A. Amendola, Naipy Perez, Xiaodong Wu, Jesús Blanco Suarez
DOI: 10.1016/j.rpor.2015.08.001
·
Rep Pract Oncol Radiother 2015;20(6):440-445.

open access

Vol 20, No 6 (2015)
Special Issue Papers
Published online: 2015-11-01
Submitted: 2015-01-07

Abstract

Aim

Our purpose is to construe the role of stereotactic body radiation therapy (SBRT) in the management of lung cancer from our early experience with SBRT for salvage treatment in patients with recurrent lung cancer after initial radiation therapy.

Background

Locoregional recurrences are a frequent challenge in patients treated with radio-chemotherapy for locally advanced NSCLC. Conventional external beam radiation therapy (EBRT) is rarely given as salvage treatment because of the risk of toxicity. There is a paucity of published studies evaluating the role of SBRT in this clinical setting.

Materials and methods

Between 2008 and present, 10 patients with biopsy proven non-small cell lung cancer (NSCLC) underwent 14 radiosurgical procedures for salvage therapy after failing initial radiation treatment. Patients’ age ranged from 54 to 88 years with a median of 74 years in 6 males and 4 females. Intervals from initial radiation treatment to salvage SBRT were 3–33 months with a median of 13 months. SBRT treatments were delivered using Intensity Modulated Volumetric Arc Therapy (VMAT). All patients received concomitant chemotherapy.

Results

Overall survival after salvage radiosurgery ranged from 6 to 41 months (mean 20 months, median 18 months). Four of the ten patients are alive with disease locally controlled. Of the remaining 6 patients, 4 had distant progression of disease with brain metastases and one had both brain and lung metastases. The other patient had a regional failure. Toxicities were found in three of the ten (30%) patients with grade I pneumonitis.

Conclusion

In our early experience, salvage SBRT is an effective modality of treating patients who failed after conventional irradiation, achieving excellent results in terms of local control with acceptable toxicity. Further prospective studies are needed to determine optimal fractionation schemes.

Abstract

Aim

Our purpose is to construe the role of stereotactic body radiation therapy (SBRT) in the management of lung cancer from our early experience with SBRT for salvage treatment in patients with recurrent lung cancer after initial radiation therapy.

Background

Locoregional recurrences are a frequent challenge in patients treated with radio-chemotherapy for locally advanced NSCLC. Conventional external beam radiation therapy (EBRT) is rarely given as salvage treatment because of the risk of toxicity. There is a paucity of published studies evaluating the role of SBRT in this clinical setting.

Materials and methods

Between 2008 and present, 10 patients with biopsy proven non-small cell lung cancer (NSCLC) underwent 14 radiosurgical procedures for salvage therapy after failing initial radiation treatment. Patients’ age ranged from 54 to 88 years with a median of 74 years in 6 males and 4 females. Intervals from initial radiation treatment to salvage SBRT were 3–33 months with a median of 13 months. SBRT treatments were delivered using Intensity Modulated Volumetric Arc Therapy (VMAT). All patients received concomitant chemotherapy.

Results

Overall survival after salvage radiosurgery ranged from 6 to 41 months (mean 20 months, median 18 months). Four of the ten patients are alive with disease locally controlled. Of the remaining 6 patients, 4 had distant progression of disease with brain metastases and one had both brain and lung metastases. The other patient had a regional failure. Toxicities were found in three of the ten (30%) patients with grade I pneumonitis.

Conclusion

In our early experience, salvage SBRT is an effective modality of treating patients who failed after conventional irradiation, achieving excellent results in terms of local control with acceptable toxicity. Further prospective studies are needed to determine optimal fractionation schemes.

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Keywords

Lung cancer; Radiosurgery; Radiation therapy; Salvage; SBRT

About this article
Title

Local failure after primary radiotherapy in lung cancer: Is there a role for SBRT?

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 20, No 6 (2015)

Pages

440-445

Published online

2015-11-01

DOI

10.1016/j.rpor.2015.08.001

Bibliographic record

Rep Pract Oncol Radiother 2015;20(6):440-445.

Keywords

Lung cancer
Radiosurgery
Radiation therapy
Salvage
SBRT

Authors

Beatriz E. Amendola
Marco A. Amendola
Naipy Perez
Xiaodong Wu
Jesús Blanco Suarez

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