BACKGROUND AND PURPOSE: Options are limited for patients with intrathoracic recurrence of non-small cell lung cancer (NSCLC) who previously received radiation. We report our 5-year experience with the toxicity and efficacy of proton beam therapy (PBT) for reirradiation. MATERIALS AND METHODS: Thirty-three patients underwent PBT reirradiation for intrathoracic recurrent NSCLC at a single institution. All patients had had RT for NSCLC (median initial dose 63 Gy in 33 fractions), with median interval to reirradiation of 36 months. Median reirradiation dose was 66 Gy (RBE) in 32 fractions. Toxicity was scored with CTCAE v4.0, and survival outcomes were estimated using Kaplan-Meier. RESULTS: Thirty-one patients (94%) completed reirradiation. At a median 11 months' follow-up, 1-year rates of overall survival, progression-free survival, locoregional control, and distant metastasis-free survival were 47%, 28%, 54%, and 39%. Rates of severe (grade ≥3) toxicity were 9% esophageal, 21% pulmonary; 1 patient had grade 4 esophagitis, and 2 had grade 4 pulmonary toxicity. Nine patients experienced a second in-field failure. CONCLUSIONS: PBT is an option for treating recurrent NSCLC. However, the rates of locoregional recurrence and distant metastasis are high and the potential for toxicity significant. The risks and benefits of PBT must be carefully weighed in each case.
BACKGROUND AND PURPOSE: Options are limited for patients with intrathoracic recurrence of non-small cell lung cancer (NSCLC) who previously received radiation. We report our 5-year experience with the toxicity and efficacy of proton beam therapy (PBT) for reirradiation. MATERIALS AND METHODS: Thirty-three patients underwent PBT reirradiation for intrathoracic recurrent NSCLC at a single institution. All patients had had RT for NSCLC (median initial dose 63 Gy in 33 fractions), with median interval to reirradiation of 36 months. Median reirradiation dose was 66 Gy (RBE) in 32 fractions. Toxicity was scored with CTCAE v4.0, and survival outcomes were estimated using Kaplan-Meier. RESULTS: Thirty-one patients (94%) completed reirradiation. At a median 11 months' follow-up, 1-year rates of overall survival, progression-free survival, locoregional control, and distant metastasis-free survival were 47%, 28%, 54%, and 39%. Rates of severe (grade ≥3) toxicity were 9% esophageal, 21% pulmonary; 1 patient had grade 4 esophagitis, and 2 had grade 4 pulmonary toxicity. Nine patients experienced a second in-field failure. CONCLUSIONS: PBT is an option for treating recurrent NSCLC. However, the rates of locoregional recurrence and distant metastasis are high and the potential for toxicity significant. The risks and benefits of PBT must be carefully weighed in each case.
Authors: Christoph Pöttgen; Jehad Abu Jawad; Eleni Gkika; Lutz Freitag; Wolfgang Lübcke; Stefan Welter; Thomas Gauler; Martin Schuler; Wilfried Ernst Erich Eberhardt; Georgios Stamatis; Martin Stuschke Journal: J Thorac Dis Date: 2015-03 Impact factor: 2.895
Authors: Xin Shelley Wang; Qiuling Shi; Loretta A Williams; Ritsuko Komaki; Daniel R Gomez; Steven H Lin; Joe Y Chang; Michael S O'Reilly; Raza H Bokhari; James D Cox; Radhe Mohan; Charles S Cleeland; Zhongxing Liao Journal: J Pain Symptom Manage Date: 2016-02-16 Impact factor: 3.612
Authors: Andrew R Barsky; Vishruth K Reddy; John P Plastaras; Edgar Ben-Josef; James M Metz; Andrzej P Wojcieszynski Journal: J Gastrointest Oncol Date: 2020-02