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High-Dose Thoracic Re-irradiation of Lung Cancer Using Highly Conformal Radiotherapy Is Effective with Acceptable Toxicity
- Source :
- Cancer Research and Treatment : Official Journal of Korean Cancer Association
- Publication Year :
- 2019
- Publisher :
- Korean Cancer Association, 2019.
-
Abstract
- 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.
- Subjects :
- Adult
Male
0301 basic medicine
Re-Irradiation
Cancer Research
medicine.medical_specialty
Lung Neoplasms
Intensity modulated radiotherapy
Pulmonary toxicity
medicine.medical_treatment
Urology
Conformal radiotherapy
Radiosurgery
03 medical and health sciences
0302 clinical medicine
medicine
Humans
Lung cancer
Aged
Retrospective Studies
Aged, 80 and over
Equivalent dose
business.industry
Radiotherapy Dosage
Middle Aged
medicine.disease
Survival Analysis
Progression-Free Survival
Radiotherapy, Computer-Assisted
Acute toxicity
Treatment Outcome
030104 developmental biology
Oncology
030220 oncology & carcinogenesis
Toxicity
Original Article
Re-irradiation
Female
Radiotherapy, Intensity-Modulated
Radiotherapy, Conformal
business
Subjects
Details
- ISSN :
- 20059256 and 15982998
- Volume :
- 51
- Database :
- OpenAIRE
- Journal :
- Cancer Research and Treatment
- Accession number :
- edsair.doi.dedup.....8e0f20c574a16e5047372bb9f3aa825b