PURPOSE: To retrospectively analyze opacity changes near primary lung cancer tumors irradiated by using hypofractionated stereotactic radiotherapy (HSRT) to determine the presence or absence of tumor recurrence. METHODS AND MATERIALS: After review-board approval for a retrospective study, we examined data from 50 patients treated with curative intent for proven or highly suspected localized peripheral-lung cancer and followed up for at least 12 months. All patients had received 50 Gy in five fractions (80% isodose) and were followed up monthly with chest X-ray until clinical and X-ray findings stabilized. Follow-up computed tomography scans were performed 1 and 3 months after HSRT and thereafter at 3-month intervals during the first 2 years. RESULTS: Median follow-up was 30.4 months (range, 12.0-73.8 months). Abnormal opacities that were suspicious for recurrent tumor appeared in 20 patients at a median of 20.7 months (range, 5.9-61.4 months). Only 3 patients were finally found to have recurrence; 14 were recurrence free but were suspected to have fibrosis, and findings for the other 3 patients were considered equivocal because of a short follow-up period (<or=6 months). CONCLUSION: Radiation fibrosis, which may occur 1 year or longer after completion of HSRT, is difficult to distinguish from tumor recurrence. Even when opacities increase on follow-up radiologic scans, recurrence cannot be diagnosed conclusively based on image findings; biopsy occasionally is warranted.
PURPOSE: To retrospectively analyze opacity changes near primary lung cancer tumors irradiated by using hypofractionated stereotactic radiotherapy (HSRT) to determine the presence or absence of tumor recurrence. METHODS AND MATERIALS: After review-board approval for a retrospective study, we examined data from 50 patients treated with curative intent for proven or highly suspected localized peripheral-lung cancer and followed up for at least 12 months. All patients had received 50 Gy in five fractions (80% isodose) and were followed up monthly with chest X-ray until clinical and X-ray findings stabilized. Follow-up computed tomography scans were performed 1 and 3 months after HSRT and thereafter at 3-month intervals during the first 2 years. RESULTS: Median follow-up was 30.4 months (range, 12.0-73.8 months). Abnormal opacities that were suspicious for recurrent tumor appeared in 20 patients at a median of 20.7 months (range, 5.9-61.4 months). Only 3 patients were finally found to have recurrence; 14 were recurrence free but were suspected to have fibrosis, and findings for the other 3 patients were considered equivocal because of a short follow-up period (<or=6 months). CONCLUSION: Radiation fibrosis, which may occur 1 year or longer after completion of HSRT, is difficult to distinguish from tumor recurrence. Even when opacities increase on follow-up radiologic scans, recurrence cannot be diagnosed conclusively based on image findings; biopsy occasionally is warranted.
Authors: S Adebahr; S Collette; E Shash; M Lambrecht; C Le Pechoux; C Faivre-Finn; D De Ruysscher; H Peulen; J Belderbos; R Dziadziuszko; C Fink; M Guckenberger; C Hurkmans; U Nestle Journal: Br J Radiol Date: 2015-04-15 Impact factor: 3.039
Authors: David A Palma; Joseph K Salama; Simon S Lo; Suresh Senan; Tom Treasure; Ramaswamy Govindan; Ralph Weichselbaum Journal: Nat Rev Clin Oncol Date: 2014-06-24 Impact factor: 66.675
Authors: Jing Zhao; Ellen D Yorke; Ling Li; Brian D Kavanagh; X Allen Li; Shiva Das; Moyed Miften; Andreas Rimner; Jeffrey Campbell; Jinyu Xue; Andrew Jackson; Jimm Grimm; Michael T Milano; Feng-Ming Spring Kong Journal: Int J Radiat Oncol Biol Phys Date: 2016-03-25 Impact factor: 7.038