Predictors and Patterns of Regional Recurrence Following Lung SBRT: A Report From the Elekta Lung Research Group

Giuliani, Meredith; Hope, Andrew; Mangona, V.S.; Gückenberger, Matthias; Mantel, Frederick; Peulen, Heike M.U.; Sonke, Jan‐Jakob; Belderbos, J.; Werner‐Wasik, Maria; Hong, Ye; Grills, I.S.

doi:10.1016/j.cllc.2016.10.006

Cited by 20 publications

(10 citation statements)

References 32 publications

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“…In addition, this study included patients with early-stage lung cancer treated with radiosurgery. According to several previous studies, the loco-regional recurrence rates were 5–15% in patients with early-stage lung cancer who were treated with radiosurgery, 5 , 17 – 19 and only 5 patients (12.5%) experienced loco-regional recurrences in this study. The small sample size and rare events might have resulted in this study being underpowered to detect existing differences in the statistical analysis.…”

Section: Discussionsupporting

confidence: 48%

<p>Reactive Oxygen Species Modulator 1 is Associated with Poor Survival in Patients with Non-Small Cell Lung Cancer After Stereotactic Fractionated Radiosurgery: A Retrospective Pilot Study</p>

Kong

Sung

Lee

2020

OTT

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Purpose: It has been reported that the overexpression of reactive oxygen species modulator 1 (Romo1) is significantly associated with poor survival outcomes in patients with lung cancer who received surgical resection, conventional fractionated radiotherapy, and chemotherapy. In this study, we investigated whether Romo1 expression is associated with survival outcomes in patients with early-stage lung cancer who were treated with radiosurgery. Methods: Romo1 protein expression was evaluated and scored in the tumor tissue specimens of 40 patients with non-small cell lung cancer by immunohistochemistry. An optimal cutoff for Romo1 expression was determined and used to allocate patients to low or high Romo1 expression groups. Survival outcomes were compared between the two groups. Results: Romo1 expression was significantly associated with distant metastasis-free survival. The 1-and 2-year distant metastasis-free survival rates were 96.4% and 92.6% in the low Romo1 expression group and 87.5% and 46.7% in the high Romo1 expression group (P=0.041), respectively. The overall, local recurrence-free, regional recurrence-free, and disease progression-free survival rates were higher in the low Romo1 expression group than the high Romo1 expression group. However, the differences were not statistically significant. Conclusion: Romo1 overexpression is associated with poor distant metastasis-free survival in patients with non-small cell lung cancer treated with radiosurgery. Further, large-scale prospective studies are required to identify the clinical efficacy of Romo1 as a potential adverse prognostic factor in lung cancer.

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Section: Discussionsupporting

confidence: 48%

<p>Reactive Oxygen Species Modulator 1 is Associated with Poor Survival in Patients with Non-Small Cell Lung Cancer After Stereotactic Fractionated Radiosurgery: A Retrospective Pilot Study</p>

Kong

Sung

Lee

2020

OTT

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“…Previous reports showed the 2-year cumulative incidence of nodal and distant recurrences were 9.0-16.1%, and 14.6-15.5%, respectively (14,15). They found no variables associated with regional recurrence, and tumor size was an independently significant predictor for distant recurrence.…”

Section: Discussionmentioning

confidence: 80%

Pattern of recurrence after CyberKnife stereotactic body radiotherapy for peripheral early non-small cell lung cancer

Nakamura¹,

Nishikawa²,

Mayahara³

et al. 2019

J. Thorac. Dis

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Background: The treatment efficacy after CyberKnife stereotactic body radiotherapy (SBRT) have not been adequately addressed. The purpose of this study was to investigate pattern of recurrence according to irradiation field after CyberKnife SBRT for early-stage non-small cell lung cancer (NSCLC). Methods: This retrospective study included patients with peripheral cT1/2N0M0 NSCLC that was treated with SBRT using a CyberKnife between May 2013 and March 2016 at single institute and followed up by more than two imaging examinations. Both operable and inoperable patients were included. Overall survival (OS) and progression-free survival (PFS) curves were estimated using the Kaplan-Meier method with 95% confidence intervals (CI). Cumulative incidence curves of recurrence were calculated and compared using the Gray's test. Results: Total 71 patients were included and analyzed in this study. The median follow-up period for surviving patients was 34 months (range, 7-64 months). The 2-year OS and PFS rate were 93% (95% CI: 83-97%) and 77% (95% CI: 65-86%), respectively. The 2-year cumulative incidence rate of infield recurrence and out-of-field recurrence were 6% (95% CI: 2-14%) and 17% (95% CI: 9-27%), respectively. Gross tumor volume (GTV) ≥9 mL and diagnosis-to-treatment interval (DTI) ≥90 days were significantly associated with infield recurrence (P<0.001 and P=0.007), and epidermal growth factor receptor (EGFR) mutation was significantly associated with out-of-field recurrence (P=0.014). Conclusions: Treatment efficacy after CyberKnife SBRT for peripheral early-stage NSCLC was identical to previous conventional linac-based SBRT reports. With short follow-up period, it was found that GTV and DTI were the significant predictive factor of infield recurrence, and EGFR mutation was the significant predictive factor of out-of-field recurrence.

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“…Giuliani et al reported that 13.4% of 965 patients who received image-guided SBRT for early-stage NSCLC had regional recurrence. 40 Thus, regional nodal oligo-recurrences after definitive treatments may be indications for SBRT in patients with NSCLC.…”

Section: Non-small Cell Lung Cancermentioning

confidence: 99%

Stereotactic Radiotherapy for Oligometastases in Lymph Nodes—A Review

Matsushita

Jingu

Umezawa

et al. 2018

Technol Cancer Res Treat

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In recent years, the concept of oligometastases has become accepted and reports on stereotactic body radiotherapy as a treatment method have been published. Lesions in the brain, lung, and liver have been reported as target lesions. However, lymph node oligometastases could be a good candidate for stereotactic body radiotherapy as well. In this study, the usability of stereotactic body radiotherapy for oligometastases to lymph nodes is assessed by researching for each primary site. As a result, we could consider that stereotactic body radiotherapy could be almost well applied for lymph node oligometastases from the breast, gynecological organs, and prostate. However, doubts remain concerning the usefulness of stereotactic body radiotherapy for cervical node metastases from head and neck cancer or for mediastinal node metastases from lung or esophageal cancer since late toxicities have occurred with a large radiation dose at hypofractionation to major vessels or the central respiratory tract, especially in patients with irradiation histories. In addition, high-dose irradiation is required to control lymph node metastases from colorectal cancer due to its radioresistance, and severe late adverse events would therefore occur in adjacent organs such as the gastrointestinal tract. In cases of lymph node oligometastases with a primary tumor in the stomach or esophagus, stereotactic body radiotherapy should be used limitedly at present because this patient population is not so large and these metastases are often located close to organs at risk. Because of the varied status of recurrence and varied conditions of patients, it is difficult to determine the optimal dose for tumor control. It might be reasonable to determine the treatment dose individually based on dose constraints of adjacent organs. The oligometastatic state is becoming more frequently identified with more sensitive methods of detecting such oligometastases. In addition, there seems to be another type of oligometastases, so-called induced oligometastases, following successful systemic treatment. To determine the optimal indication of stereotactic body radiotherapy for lymph node oligometastases, further investigation about the mechanisms of oligometastases and further clinical studies including a phase III study are needed.

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Predictors and Patterns of Regional Recurrence Following Lung SBRT: A Report From the Elekta Lung Research Group

Cited by 20 publications

References 32 publications

<p>Reactive Oxygen Species Modulator 1 is Associated with Poor Survival in Patients with Non-Small Cell Lung Cancer After Stereotactic Fractionated Radiosurgery: A Retrospective Pilot Study</p>

<p>Reactive Oxygen Species Modulator 1 is Associated with Poor Survival in Patients with Non-Small Cell Lung Cancer After Stereotactic Fractionated Radiosurgery: A Retrospective Pilot Study</p>

Pattern of recurrence after CyberKnife stereotactic body radiotherapy for peripheral early non-small cell lung cancer

Stereotactic Radiotherapy for Oligometastases in Lymph Nodes—A Review

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