Stereotactic Body Radiotherapy for Synchronous Primary Lung Cancer: Clinical Outcome of 18 Cases

Satō, Takashi; Masago, Katsuhiro; Takayama, Kenji; Ueki, Kunikazu; Kimino, Genki; Ueki, N.; Kosaka, Yasuhiro; Imagumbai, Toshiyuki; Katakami, Nobuyuki; Kitajima, Masaki

doi:10.1016/j.cllc.2014.12.011

Cited by 24 publications

(11 citation statements)

References 27 publications

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“…These were basically consistent with other researches [2][3][4][5][6][7]. The research of Shintani, T. et al [13] found that in SMPLC patients only treated with stereotactic body radiotherapy (SBRT), the 3-year OS rate and DFS rate were 69.1% and 43.2%, far lower than the surgical-based comprehensive treatment. Other studies also supported this conclusion [14][15].Comprehensive studies had shown that the prognosis of patients with SMPLC was better than that of patients with lung cancer recurrence or metastasis [2][3][4][5][6][7].…”

Section: Discussionsupporting

confidence: 89%

What are the Survival Factors in Surgically Resected Synchronous Multiple Primary Lung Cancers: A Retrospective Study

Wang

Zhang

et al. 2020

Preprint

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Background: With the popularization of high-resolution computed tomography (HRCT), the detection rate of synchronous multiple primary lung cancer (SMPLC) is increasing. We retrospectively analyzed the surgical results of SMPLC patients in our hospital to determine the best treatment for SMPLC.Methods: A total of 90 SMPLC patients met the diagnostic criteria underwent complete resection and lymph node dissection or sampling without any preoperative induction therapy in the Department of Thoracic Surgery, Qilu Hospital, Cheeloo College of Medicine, Shandong University. We analyzed the postoperative survival rate, and further studied the relationship between survival rates and sex, age, preoperative symptoms, tumor location, tumor number, tumor size, surgical type, surgical frequency, histopathologic types, vascular infiltration, visceral pleural invasion and postoperative therapy.Results: Among 90 patients, the 1- and 3-year disease free survival (DFS) rates were 97.0% and 76.7% while the 1- and 3-year overall survival (OS) rates were 98.81% and 82.35%. Vascular infiltration (HR=402.46, p=0.005) and postoperative chemotherapy (HR>1000, p<0.001) were independent risk factors for DFS, while only postoperative chemotherapy (HR=184.10, p=0.002) was an independent risk factor for OS.Conclusions: First, SMPLC is different from intrapulmonary metastasis and its clinical stage is also different from the 8th (2015) edition TNM classification for lung cancer. Second, when pulmonary function permits, surgery (complete resection and lymph node dissection) is a significantly beneficial treatment for patients with SMPLC. Third, for early stage SMPLC patients, vascular infiltration and postoperative chemotherapy are harmful to the survival.

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Section: Discussionsupporting

confidence: 89%

What are the Survival Factors in Surgically Resected Synchronous Multiple Primary Lung Cancers: A Retrospective Study

Wang

Zhang

et al. 2020

Preprint

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“…Chronic grade 3 toxicity was seen in 10% of the total cohort of 30 patients, and no grade 4 or 5 toxicity was reported. Another report on 15 patients with NSCLC who underwent subsequent SABR for a second tumor reported grade 3 RP in 7% [15]. Similarly, Rose et al [16] observed a total rate of 2% for late highgrade pulmonary toxicity after SABR with VMAT in their study group of 60 NSCLC patients with lung metastatic disease (33% of patients had two or more lesions).…”

Section: Discussionmentioning

confidence: 96%

Optimizing SABR delivery for synchronous multiple lung tumors using volumetric-modulated arc therapy

et al. 2017

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Background: Volumetric-modulated arc therapy (VMAT) delivery for stereotactic ablative radiotherapy (SABR) of multiple lung tumors allows for faster treatments. We report on clinical outcomes and describe a general approach for treatment planning. Material and methods: Patients undergoing multi iso-center VMAT-based SABR for !2 lung lesions between 2009 and 2014 were identified from the VU University Medical Center and London Health Sciences Centre. Patients were eligible if the start date of the SABR treatment for the different lesions was within a time range of 30 days. SABR was delivered using separate iso-centers for lesions at a substantial distance from each other. Tumors were either treated with a single fraction of 34 Gy, or using three risk-adapted dose-fractionation schemes, namely three fractions of 18 Gy, five fractions of 11 Gy, or eight fractions of 7.5 Gy, depending on the tumor size and the location. Multivariable analysis was performed to assess factors predictive of clinical outcomes. Results: Of 84 patients (188 lesions) identified, 46% were treated for multiple metastases and 54% for multiple primary NSCLC. About 97% were treated for two or three lesions, and 56% had bilateral disease. After a median follow-up of 28 months, median overall survival (OS) for primary tumors was 27.6 months, and not reached for metastatic lesions (p ¼ .028). Grade !3 toxicity was observed in 2% of patients. Multivariable analysis showed that grade 2 or higher radiation pneumonitis (n ¼ 9) was best predicted by a total lung V35 Gy of !6.5% (in 2Gy/fraction equivalent) (p ¼ .007). Conclusion: Severe toxicity was uncommon following SABR using VMAT for up to three lung tumors. Further investigations of planning parameters are needed in patients presenting with more lesions.

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“…Other factors like old patient age [32][33][34], severe comorbidities and poor pulmonary function should not prevent recommendation of SBRT as a curative and well tolerated option [35][36][37]. Clinical situations, which are potentially associated with an increased risk for toxicity, do not preclude use of SBRT, for example following a contralateral pneumonectomy [38][39][40], treatment of two simultaneous primaries [41,42] and treatment of centrally located NSCLC [43,44]. Recently, idiopathic pulmonary fibrosis (IPF) has been identified as a risk factor for severe radiation induced pneumonitis but was not a relative contraindication for SBRT in the majority of the institutions [45][46][47].…”

Section: Discussionmentioning

confidence: 99%

ESTRO ACROP consensus guideline on implementation and practice of stereotactic body radiotherapy for peripherally located early stage non-small cell lung cancer

Gückenberger

Andratschke

Dieckmann

et al. 2017

Radiotherapy and Oncology

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210

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Stereotactic Body Radiotherapy for Synchronous Primary Lung Cancer: Clinical Outcome of 18 Cases

Cited by 24 publications

References 27 publications

What are the Survival Factors in Surgically Resected Synchronous Multiple Primary Lung Cancers: A Retrospective Study

What are the Survival Factors in Surgically Resected Synchronous Multiple Primary Lung Cancers: A Retrospective Study

Optimizing SABR delivery for synchronous multiple lung tumors using volumetric-modulated arc therapy

ESTRO ACROP consensus guideline on implementation and practice of stereotactic body radiotherapy for peripherally located early stage non-small cell lung cancer

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