Stereotactic body radiation therapy for a new lung cancer arising after pneumonectomy: dosimetric evaluation and pulmonary toxicity

Testolin, A.; Favretto, Maria Silvia; Cora, S.; Cavedon, Carlo

doi:10.1259/bjr.20150228

Cited by 19 publications

(10 citation statements)

References 76 publications

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“…31 Therefore, SBRT is often performed only on the basis of imaging diagnosis, without pathological diagnosis. 32,33 Because biopsy and surgery may show different histological tumor types, as observed in Case 2, the imaging and pathological diagnoses are often different. With regard to the prognosis reported for SBRT, previous studies might have included patients with benign disease; therefore, the prognosis could be overestimated.…”

Section: Discussionmentioning

confidence: 99%

“…However, iatrogenic pneumothorax has been reported to occur in 13%–25% of the patients who undergo percutaneous lung biopsy 11, 30 and 1%–6% of those who undergo bronchial lung biopsy 31 . Therefore, SBRT is often performed only on the basis of imaging diagnosis, without pathological diagnosis 32, 33 . Because biopsy and surgery may show different histological tumor types, as observed in Case 2, the imaging and pathological diagnoses are often different.…”

Section: Discussionmentioning

confidence: 99%

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Contralateral pulmonary resection using selective bronchial blockade in postpneumonectomy patients

et al. 2020

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Background: Pulmonary resection is occasionally performed in postpneumonectomy patients with contralateral lung lesions, such as metachronous or metastatic lung cancer. Careful intraoperative respiratory management is essential in such patients. This study evaluated the respiratory management of postpneumonectomy patients who underwent contralateral pulmonary resection with selective bronchial blockade of the lobe or segment to be resected. Methods: We retrospectively analyzed the surgical findings and safety of surgery in six patients who underwent contralateral pulmonary resection with selective bronchial blockade after pneumonectomy for non-small cell lung cancer (NSCLC). Results: The percutaneous oxygen saturation did not decrease in any of the patients during bronchial blockade under high oxygen concentration. The median blockade time was 57.5 minutes. The operative field was tolerable secured under conditions of partial lung collapse, and partial pulmonary resection was performed as planned. Postoperatively, one patient developed acute respiratory distress syndrome due to acute exacerbation of interstitial pneumonia; however, no patients died within one month postoperatively. Two patients underwent pulmonary resection in order to obtain adequate tissue specimens to evaluate the biomarkers of multiple lung metastases. On histopathology, one patient tested positive for anaplastic lymphoma kinase (ALK) and was subsequently administered an ALK inhibitor, which prolonged survival. Conclusions: In all patients, intraoperative respiratory condition under partial lung collapse remained stable, and all partial pulmonary resections were safely performed. However, surgical indications should be carefully reviewed preoperatively in patients with interstitial pneumonia.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Contralateral pulmonary resection using selective bronchial blockade in postpneumonectomy patients

et al. 2020

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“…They included thermal ablation, radiofrequency ablation, conventional radiotherapy and stereotactic body radiotherapy. These techniques prove their major efficacy in small peripheral nodules and show a non-negligible risk of toxicity and local recurrences (6). Often nonsurgical approaches are performed without any histological diagnosis of a lung nodule, because biopsy is considered too dangerous for single-lung patient.…”

Section: Discussionmentioning

confidence: 99%

Thoracoscopic wedge resection in single-lung patients

Zampieri¹,

Marulli²,

Comacchio³

et al. 2018

J. Thorac. Dis.

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Thoracoscopic surgery represents a feasible surgical option in selected patients after contralateral pneumonectomy, with careful preoperative assessment and using short apnea windows in good collaboration with anesthesiologists. Histological definition, made possible by the surgical-procedure, gives patients the possibility to eventually undergo further targeted therapies. Randomized prospective trials are necessary to assess the best management of peripheral small lung nodules in single-lung patients, in particular to define which patients can benefit from a surgical approach.

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“…The radiologic changes seen at CT after lung SBRT differ from the changes after conventional radiation therapy in extent, time of manifestation, and appearance because of the complex beam arrangements and the targeted high radiation dose. It is important to be able to recognize the early and late CT changes after lung SBRT, recurrent cancer at the surgical margin can also be treated with SBRT, especially if additional surgery is not an option (24) (Fig 4).…”

Section: Locally Recurrent Nsclc In Previously Irradiated Lung or Aftmentioning

confidence: 99%

Stereotactic Body Radiation Therapy for Early-Stage Non–Small Cell Lung Cancer: A Primer for Radiologists

2018

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The past 2 decades have seen a rapid growth in use of stereotactic body radiation therapy (SBRT) for the management of non-small cell lung cancer (NSCLC). Not only is SBRT the reference standard for treatment of early-stage node-negative NSCLC in medically inoperable patients, it is also currently challenging the role of surgery for early-stage operable disease. SBRT is also used to treat recurrent disease and has a role in the management of multiple synchronous lung cancers. Imaging changes after SBRT differ from the changes after conventional radiation therapy in many ways, the knowledge of which is pertinent for accurate image interpretation. Posttreatment response assessment and detection of recurrent disease are heavily reliant on radiologic assessment, and often the decision to treat recurrent disease is based on the imaging findings themselves. This article provides a comprehensive review of the concepts of SBRT and the current indications for its use in the treatment of early-stage NSCLC, as well as a discussion of the CT findings seen after SBRT compared with the changes after conventional radiation therapy. Radiologic findings that are suggestive of recurrent disease and the imaging pitfalls are also highlighted. Finally, the rare complications after SBRT are described. SBRT is a major component of the changing treatment paradigms for early- and late-stage NSCLC. The imaging findings after SBRT often determine the next steps in a patient's clinical management. Therefore, radiologists must be familiar with the uses of this therapy and its radiologic appearance to be able to effectively contribute to the care of patients with NSCLC. RSNA, 2018.

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Stereotactic body radiation therapy for a new lung cancer arising after pneumonectomy: dosimetric evaluation and pulmonary toxicity

Cited by 19 publications

References 76 publications

Contralateral pulmonary resection using selective bronchial blockade in postpneumonectomy patients

Contralateral pulmonary resection using selective bronchial blockade in postpneumonectomy patients

Thoracoscopic wedge resection in single-lung patients

Stereotactic Body Radiation Therapy for Early-Stage Non–Small Cell Lung Cancer: A Primer for Radiologists

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