Non-small-cell lung cancer: reirradiation for loco-regional relapse previously treated with radiation therapy

Abstract

Reirradiation is considered to contribute to salvage in selected patients with relapsed non-small-cell lung cancer. Patients with a long interval after the initial irradiation are good candidates for reirradiation. On the other hand, patients with Eastern Cooperative Oncology Group (ECOG) performance status 3 were not good candidates.

Re-Irradiation of Locoregional NSCLC Recurrence Using Robotic Stereotactic Body Radiotherapy

“…Tada et al [5] reported that the OS rates for 19 patients who were re-irradiated with conformal radiotherapy were 26 and 11% for years 1 and 2, respectively. A comparison of our SBRT result with published data by Wu et al [4] who used 3DCRT shows that a better local control rate can be obtained with SBRT with a 1-year rate of 69% compared to 51%.…”

“…Because patients with locoregional relapse or second cancers in the thoracic region after definitive radiotherapy are generally not suitable for surgery and the response rates to second-line chemotherapy are low without the provision of durable control [3], re-irradiation remains as a treatment option using limited radiation doses which can be tolerated by the surrounding previously irradiated critical tissues. Palliative or definitive re-irradiation of locally recurrent or persistent NSCLC using conventional radiotherapy has been explored by multiple groups reporting variable success with 2-year locoregional control rates of only 42% at a median dose of 51 Gy [4][5][6]. In their review, Jeremic et al [7] summarized that conventional external beam radiotherapy (EBRT) for re-irradiation of recurrent lung cancer yields suboptimal local control rates of 50-60% and a 3-5% risk of grade 3 or higher toxicity.…”

Salvage SBRT for Previously Irradiated Lung Cancer

“…[4] Re-irradiation with conventional radiation has been reported as well with variable success. [5][6][7][8][9] Stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (SRT) have become routine treatment options for patients with brain metastases. [10][11][12][13][14][15] High fractional dose is more effective for radiation resistant cells.…”

Twenty-six years follow up of bronchio-alveolar lung cancer using local surgical and repeated radiation techniques

“…The real impact of time intervals needs to be studied in better established prospective protocols and cannot be answered in the framework of this case study. Tada, et al [6] reported on the feasibility of repeated irradiations using longer time intervals.…”