1. Reirradiation with stereotactic body radiotherapy for primary or secondary lung malignancies: Tumor control probability and safety analyses.
- Author
-
Wang, Huan-Huan, Chen, Yuan, Liu, Xin, Zaorsky, Nicholas G, Mani, Kyle, Niu, Zhi-Min, Zheng, Bo-Yu, Zeng, Hong-Yu, Yan, Yuan-Yuan, Li, Yan-Jin, He, Yuan, Ji, Chao-Zhi, Sun, Bing-Sheng, and Meng, Mao-Bin
- Subjects
- *
STEREOTACTIC radiotherapy , *LUNG tumors , *PATIENT selection , *MEDICAL dosimetry , *PATIENTS' attitudes - Abstract
• Reirradiation with SBRT for primary or secondary lung malignancies presents an appealing and definitive approach, but its feasibility and safety are not well defined. • Reirradiation with SBRT doses of 50–60 Gy in 3–5 fractions is feasible for appropriately selected patients experiencing recurrence of peripheral primary or secondary lung malignancies. • Reirradiation with SBRT for centrally-located tumors warrants careful consideration due to the potential risk of severe toxicity. • Further studies are warranted to determine optimal dose/fractionation schedules and improve the appropriate selection of patients suitable for reirradiation with SBRT. Reirradiation with stereotactic body radiotherapy (SBRT) for patients with primary or secondary lung malignancies represents an appealing definitive approach, but its feasibility and safety are not well defined. The purpose of this study was to investigate the tumor control probability (TCP) and toxicity for patients receiving reirradiation with SBRT. Eligible patients with recurrence of primary or secondary lung malignancies from our hospital were subjected to reirradiation with SBRT, and PubMed- and Embase-indexed articles were reviewed. The patient characteristics, pertinent SBRT dosimetric details, local tumor control, and toxicities were extracted. The logistic dose–response models were compared for TCP and overall survival (OS) in terms of the physical dose and three-, four-, and five-fraction equivalent doses. The data of 17 patients from our hospital and 195 patients extracted from 12 articles were summarized. Reirradiation with SBRT yielded 2-year estimates of 80% TCP for doses of 50.10 Gy, 55.85 Gy, and 60.54 Gy in three, four, and five fractions, respectively. The estimated TCP with common fractionation schemes were 50%, 60%, and 70% for 42.04 Gy, 47.44 Gy, and 53.32 Gy in five fractions, respectively. Similarly, the 2-year estimated OS was 50%, 60%, and 70% for 41.62 Gy, 46.88 Gy, and 52.55 Gy in five fractions, respectively. Central tumor localization may be associated with severe toxicity. Reirradiation with SBRT doses of 50–60 Gy in 3–5 fractions is feasible for appropriately selected patients with recurrence of peripheral primary or secondary lung malignancies, but should be carefully considered for centrally-located tumors due to potentially severe toxicity. Further studies are warranted for optimal dose/fractionation schedules and more accurate selection of patients suitable for reirradiation with SBRT. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF