Stereotactic Radiosurgery/Stereotactic Body Radiotherapy for Recurrent Lung Neoplasm: An Analysis of Outcomes in 100 Patients.

Abstract

BACKGROUND:

A significant number of patients have recurrent or persistent lung cancer despite complete resection or treatment with definitive chemoradiation. Stereotactic radiosurgery (SRS)/stereotactic body radiation therapy is emerging as an important modality for the treatment of early-stage lung neoplasm; SRS may also offer an alternative treatment option for patients with recurrent lung disease. We evaluated outcomes after treatment with SRS for recurrent lung neoplasm in a large series of patients.

METHODS:

Selected patients with limited recurrent, persistent, or progressive disease after one or more prior treatments for lung cancer were offered SRS. Thoracic surgeons evaluated all patients, placed fiducials when needed, and planned treatment in close collaboration with radiation oncologists and medical physicists. In our early experience, a single fraction of 20 Gy radiation was prescribed and was subsequently increased to 45 to 60 Gy in three to five fractions. The primary endpoint evaluated was overall survival.

RESULTS:

We treated 100 patients with recurrent lung cancer (median age 72 years) with SRS. The postprocedure 30-day mortality rate was 0%; median follow-up was 51 months (range, 5 to 123). The median overall survival for the entire group was 23 months (95% confidence interval: 19 to 41). The probability of 2-year and 5-year overall survival was 49% (95% confidence interval: 40% to 60%) and 31% (95% confidence interval: 23% to 43%), respectively.

CONCLUSIONS:

Our experience indicates that SRS is safe, and offers an alternative modality for selected patients with recurrent oligometastatic or persistent lung cancer. Thoracic surgeons should actively participate in SRS and continue to evaluate the efficacy of this treatment strategy.

• Authors: Arjun Pennathur, James D Luketich, Dwight E Heron, Matthew J Schuchert, Valentino Bianco, David Clump, Steven Burton, Ghulam Abbas, William E Gooding, Cihat Ozhasoglu, Rodney J Landreneau, Neil A Christie
• Journal: The Annals of thoracic surgery (Ann Thorac Surg) Vol. 100 Issue 6 Pg. 2019-24 (Dec 2015) ISSN: 1552-6259 [Electronic] Netherlands
• PMID: 26387725 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)
• Copyright: Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Topics

• Adult
• Aged
• Aged, 80 and over
• Disease Progression
• Dose-Response Relationship, Radiation
• Female
• Follow-Up Studies
• Humans
• Lung Neoplasms (mortality, surgery)
• Male
• Middle Aged
• Neoplasm Recurrence, Local (mortality, surgery)
• Pennsylvania (epidemiology)
• Radiosurgery (methods)
• Retrospective Studies
• Survival Rate (trends)
• Time Factors
• Treatment Outcome