High-Dose Thoracic Re-irradiation of Lung Cancer Using Highly Conformal Radiotherapy Is Effective with Acceptable Toxicity
| Autor: | Ju-Young Hong, So Jung Lee, Ji Hyun Hong, Sea-Won Lee, Jin Hyung Kang, GeumSeong Cheon, Yeon-Sil Kim, Suk Hee Hong |
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| Rok vydání: | 2019 |
| Předmět: |
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 |
| Zdroj: | Cancer Research and Treatment : Official Journal of Korean Cancer Association |
| ISSN: | 2005-9256 1598-2998 |
| DOI: | 10.4143/crt.2018.472 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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