Cancer Research and Treatment

Original Article

High-Dose Thoracic Re-irradiation of Lung Cancer Using Highly Conformal Radiotherapy Is Effective with Acceptable Toxicity: Ji Hyun Hong, Yeon-Sil Kim, Sea-Won Lee, So Jung Lee, Jin Hyung Kang, Suk Hee Hong, Ju-Young Hong, GeumSeong Cheon; Cancer Res Treat. 2019;51(3):1156-1166. Published online November 29, 2018; DOI: https://doi.org/10.4143/crt.2018.472

Purpose
Thoracic re-irradiation (re-RT) of lung cancer has been challenged by the tolerance doses of normal tissues. We retrospectively analyzed local control, overall survival (OS) and toxicity after thoracic re-RT using highly conformal radiotherapy, such as intensity modulated radiotherapy and stereotactic body radiotherapy.
Materials and Methods
Thirty-one patients who received high-dose thoracic re-RT were analyzed. Doses were recalculated to determine biologically equivalent doses. The median interval to re-RT was 15.1 months (range, 4.4 to 56.3 months), the median initial dose was 79.2 Gy₁₀ (range, 51.75 to 150 Gy₁₀), and the median re-RT dose was 68.8 Gy₁₀ (range, 43.2 to 132 Gy₁₀).
Results
Eighteen (58.1%) and eleven (35.5%) patients showed loco-regional recurrence and distant metastasis, respectively, after 17.4 months of median follow-up. The 1-year and 2-year local control rates were 60.2% and 43.7%, respectively. The median loco-regional recurrence-free-survival (LRFS) was 15.4 months, and the median OS was 20.4 months. The cumulative and re-RT biologically equivalent dose for α/β=10 (BED₁₀) doses were the most significant prognostic factors. Cumulative BED₁₀≥145 Gy₁₀ and re-RT BED₁₀≥68.7 Gy₁₀ were significantly associated with longer OS (p=0.029 and p=0.012, respectively) and LRFS (p=0.003 and p=0.000, respectively). The most frequent acute toxicity was grade 1-2 pulmonary toxicity (41.9%). No acute grade 3 or higher toxicities occurred.
Conclusion
Our results show that high-dose thoracic re-RT of lung cancer can be safely delivered using highly conformal radiotherapy with favorable survival and acceptable toxicity. An optimal strategy to select patients who would benefit from re-RT is crucial in extending the indications and improving the efficacy with a sufficiently high dose.

Citations

Citations to this article as recorded by

ACR-ARS Practice Parameter for the Performance of Proton Beam Therapy
Steven J. Frank, Indra J. Das, Charles B. Simone, Brian J. Davis, Curtiland Deville, Zhongxing Liao, Simon S. Lo, Susan L. McGovern, Rahul R. Parikh, Michael Reilly, William Small, Naomi R. Schechter
International Journal of Particle Therapy.2024; 13: 100021. CrossRef
Ultra-Hypofractionated Re-Irradiation with Anti-PD-1 Immunotherapy for Locoregionally Recurrent (after Radical Chemo-Radiotherapy) Non-Small Cell Lung Cancer
Konstantinos Filippatos, Ioannis M. Koukourakis, Stavros Anevlavis, Axiotis Giaktzidis, Michael I. Koukourakis
Cancers.2023; 15(20): 5083. CrossRef
Re-irradiation for intra-thoracic tumours and extra-thoracic breast cancer: dose accumulation, evaluation of efficacy and toxicity based on a literature review
Dorota Gabrys, Roland Kulik, Agnieszka Namysł-Kaletka
The British Journal of Radiology.2022;[Epub] CrossRef
High Dose Thoracic Re-Irradiation and Chemo-Immunotherapy for Centrally Recurrent NSCLC
Brane Grambozov, Markus Stana, Bernhard Kaiser, Josef Karner, Sabine Gerum, Elvis Ruznic, Barbara Zellinger, Raphaela Moosbrugger, Michael Studnicka, Gerd Fastner, Felix Sedlmayer, Franz Zehentmayr
Cancers.2022; 14(3): 573. CrossRef
Toxicity of Proton Therapy versus Photon Therapy on Salvage Re-Irradiation for Non-Small Cell Lung Cancer
Kyungmi Yang, Yang-Gun Suh, Hyunju Shin, Hongryull Pyo, Sung Ho Moon, Yong Chan Ahn, Dongryul Oh, Eunah Chung, Kwanghyun Jo, Jae Myoung Noh
Life.2022; 12(2): 292. CrossRef
Salvage proton beam therapy for locoregional recurrence of non-small cell lung cancer
Hyunju Shin, Jae Myoung Noh, Hongryull Pyo, Yong Chan Ahn, Dongryul Oh
Radiation Oncology Journal.2021; 39(1): 24. CrossRef
Thoracic re-irradiation with 3D-conformal or more advanced techniques: A systematic review of treatment safety by the Re-irradiation Study Group of the Italian Association of Radiation and Oncology AIRO
Marta Maddalo, Elisa D’Angelo, Francesco Fiorica, Angela Argenone, Melissa Scricciolo, Salvatore Cozzi, Alessia Nardangeli, Francesco Dionisi, Gianluca Costantino, Stefano Vagge, Antonio Pontoriero, Vittorio Donato, Mariangela Massaccesi
Critical Reviews in Oncology/Hematology.2021; 167: 103500. CrossRef
Radiotherapy for head and neck tumours using an oral fixation and parameter acquisition device and TOMO technology: a randomised controlled study
Xiaofang Zhang, Tianlu Wang, Xinyan Xiao, Xia Li, Chen Yu Wang, Bo Huang, Lei He, Yingqiu Song
BMJ Open.2021; 11(11): e052542. CrossRef
The Medical Physics Management of Reirradiation Patients
Kelly C. Paradis, Martha M. Matuszak
Seminars in Radiation Oncology.2020; 30(3): 204. CrossRef
Reirradiation at local relapse of non-small cell lung cancer
D.V. Gogolin, I.A. Gulidov, Y.S. Mardynsky, T.Y. Antonenko, A.Y. Buksha
Onkologiya. Zhurnal imeni P.A.Gertsena.2020; 9(3): 48. CrossRef

8,240 View
255 Download
8 Web of Science
10 Crossref

First
Prev
Page of 1
Next
Last

Search