Repeat Thoracic Stereotactic Body Radiation Therapy (SBRT) for Nonsmall Cell Lung Cancer: Long-Term Outcomes, Toxicity, and Dosimetric Considerations

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dc.contributor.authorRicco, Anthonyen
dc.contributor.authorBarlow, Saraen
dc.contributor.authorFeng, Jingen
dc.contributor.authorJacob, Jansonen
dc.contributor.authorLozano, Alicia J.en
dc.contributor.authorHanlon, Alexandra L.en
dc.contributor.authorArrigo, Stephenen
dc.contributor.authorObayomi-Davies, Olusolaen
dc.contributor.authorLamond, Johnen
dc.contributor.authorYang, Junen
dc.contributor.authorLanciano, Rachelleen
dc.contributor.departmentStatisticsen
dc.date.accessioned2021-02-08T20:02:36Zen
dc.date.available2021-02-08T20:02:36Zen
dc.date.issued2020-10en
dc.description.abstractPurpose: Lung reirradiation for nonsmall cell lung cancer (NSCLC) is common for either recurrent disease or new primary cancer. Dose volume tolerance of the lung after multiple courses of radiation therapy (RT) is unknown. We review our experience with lung reirradiation for patients with NSCLC in a single community setting using stereotactic body radiation therapy (SBRT) to report lung cumulative doses, survival, and toxicity. Methods and Materials: Forty-four patients who received at least 2 curative courses of lung RT with the second course delivered between January 2012 and December 2017 were eligible. All patients had NSCLC and were treated with SBRT for reirradiation. Cumulative lung dose volume histograms for all courses were generated, summated, and converted into cumulative equivalent dose in 2 Gy fractions (EQD2). Actuarial overall survival (OS), local control, and toxicity is reported, including a subset of patients who received more than 2 courses of SBRT. Results: Median age of the group was 71 years (range, 51-87). Median survival of the entire group from diagnosis, first, and second courses of RT was 3.94, 3.03, and 2.03 years. Three-year actuarial OS for the entire group was 34.1% from second course of RT. The mean EQD2 Gy3 mean lung dose for all courses was 12.35 Gy (range, 2.7-26.52). The mean EQD2 Gy(3) V5Gy, V10Gy, V20Gy, V30Gy, and V40Gy were 40.9%, 25.5%, 14.7%, 10.2%, and 7.7%. Six-year actuarial freedom from grade >= 3 complications was 86.3%. The rate of grade >= 3 lung toxicity was 4.5% (2 of 44). Other late toxicities included grade 3 recurrent laryngeal nerve damage (n=1) and grade 3 chest wall pain/rib fracture (n = 1). Overall, 32% of patients had more than 2 courses of RT to the lung (range, 3-7). Conclusions: Long-term OS is possible with multiple RT courses to the lung for NSCLC with low toxicity. (C) 2020 The Author(s). Published by Elsevier Inc. on behalf of American Society for Radiation Oncology.en
dc.format.mimetypeapplication/pdfen
dc.identifier.doihttps://doi.org/10.1016/j.adro.2020.06.006en
dc.identifier.eissn2452-1094en
dc.identifier.issue5en
dc.identifier.pmid33083662en
dc.identifier.urihttp://hdl.handle.net/10919/102313en
dc.identifier.volume5en
dc.language.isoenen
dc.rightsCreative Commons Attribution-NonCommercial-NoDerivs 4.0 Internationalen
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/en
dc.titleRepeat Thoracic Stereotactic Body Radiation Therapy (SBRT) for Nonsmall Cell Lung Cancer: Long-Term Outcomes, Toxicity, and Dosimetric Considerationsen
dc.title.serialAdvances in Radiation Oncologyen
dc.typeArticle - Refereeden
dc.type.dcmitypeTexten
dc.type.dcmitypeStillImageen

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