Douglas A Rahn1, Siddarth Thakur2, Samir Makani3, Ajay Sandhu1. 1. Department of Radiation Oncology, University of California - San Diego, USA. 2. Crittenton Hospital Medical Center, Wayne State University Medical School, Detroit, Michigan, USA. 3. Department of Pulmonology, University of California - San Diego, USA.
Abstract
OBJECTIVES: To review the literature and report our experience with the use of stereotactic body radiation therapy (SBRT) to treat multiple primary lung cancers (MPLCs). METHODS: A retrospective review of 18 patients with 36 separate MPLC lesions (6 synchronous pairs and 12 metachronous pairs) was performed. Of these 18 patients, 16 were not surgical candidates and 2 declined to have surgery. Of the 36 lesions treated, 27 received SBRT, 6 had received prior fractionated RT, and 3 had prior surgical resection. Radiotherapy doses for SBRT ranged from 48 to 56 Gy (Median = 50 Gy) in 4 to 13 fractions (Median = 5 fractions) and treatment plans used 4D-CT simulation scans in all patients. RESULTS: The median follow-up was 20 months after initial SBRT. We observed local control in 22 of 27 (81.5%) of the lesions treated with SBRT. The actuarial overall survival at 2 years from completion of initial SBRT course was 62%. Metastatic disease occurred in 3 of the 6 deceased patients. Clinically evident pneumonitis was observed in 3 of the 18 pts (17%), which resolved completely with steroid therapy. CONCLUSIONS: SBRT appears to be a safe and effective treatment for MPLC both solely or after prior fractionated RT or surgical resection. SBRT for MPLC is a reasonable treatment option for patients who are not optimal candidates for surgery or who decline surgery.
OBJECTIVES: To review the literature and report our experience with the use of stereotactic body radiation therapy (SBRT) to treat multiple primary lung cancers (MPLCs). METHODS: A retrospective review of 18 patients with 36 separate MPLC lesions (6 synchronous pairs and 12 metachronous pairs) was performed. Of these 18 patients, 16 were not surgical candidates and 2 declined to have surgery. Of the 36 lesions treated, 27 received SBRT, 6 had received prior fractionated RT, and 3 had prior surgical resection. Radiotherapy doses for SBRT ranged from 48 to 56 Gy (Median = 50 Gy) in 4 to 13 fractions (Median = 5 fractions) and treatment plans used 4D-CT simulation scans in all patients. RESULTS: The median follow-up was 20 months after initial SBRT. We observed local control in 22 of 27 (81.5%) of the lesions treated with SBRT. The actuarial overall survival at 2 years from completion of initial SBRT course was 62%. Metastatic disease occurred in 3 of the 6 deceased patients. Clinically evident pneumonitis was observed in 3 of the 18 pts (17%), which resolved completely with steroid therapy. CONCLUSIONS: SBRT appears to be a safe and effective treatment for MPLC both solely or after prior fractionated RT or surgical resection. SBRT for MPLC is a reasonable treatment option for patients who are not optimal candidates for surgery or who decline surgery.
Authors: Robert Timmerman; Rebecca Paulus; James Galvin; Jeffrey Michalski; William Straube; Jeffrey Bradley; Achilles Fakiris; Andrea Bezjak; Gregory Videtic; David Johnstone; Jack Fowler; Elizabeth Gore; Hak Choy Journal: JAMA Date: 2010-03-17 Impact factor: 56.272
Authors: Sameer K Nath; Ajay P Sandhu; Daniel Kim; Anjali Bharne; Polly D Nobiensky; Joshua D Lawson; Mark Fuster; Lyudmila Bazhenova; William Y Song; Arno J Mundt Journal: Radiother Oncol Date: 2011-03-21 Impact factor: 6.280
Authors: Patrick Kelly; Peter A Balter; Neal Rebueno; Hadley J Sharp; Zhongxing Liao; Ritsuko Komaki; Joe Y Chang Journal: Int J Radiat Oncol Biol Phys Date: 2010-04-08 Impact factor: 7.038
Authors: Nicolas Girard; Charuhas Deshpande; Christopher Lau; David Finley; Valerie Rusch; William Pao; William D Travis Journal: Am J Surg Pathol Date: 2009-12 Impact factor: 6.394
Authors: Cole R Steber; Ryan T Hughes; Michael H Soike; Corbin A Helis; Karina Nieto; Travis Jacobson; Moeko Nagatsuka; Hamilton S McGinnis; C Marc Leyrer; Michael K Farris Journal: Acta Oncol Date: 2021-02-27 Impact factor: 4.089