Kinj Rémy, Casutt Alessio, Bennassi Alexander, Bouchaab Hasna, Vallet Véronique, Lovis Alban, Ozsahin Mahmut
Department of Radiation Oncology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Department of Pulmonology, Lausanne University Hospital, Lausanne, Switzerland.
Clin Transl Radiat Oncol. 2021 Apr 5;28:85-87. doi: 10.1016/j.ctro.2021.03.007. eCollection 2021 May.
Local recurrence after lung SBRT for early stage NSCLC is rare but its treatment remains a challenge due to limited surgical options. We report a case series of 5 patients treated by stereotactic lung salvage reirradiation for local relapse after a previous lung SBRT.
Included patients presented an isolated primary lung relapse within at least the 50% isodose of the previous SBRT treatment. Typical reirradiation schedule was 60 Gy in 8 fractions at isodose 80% and was delivered by Cyberknife® using Synchrony® fiducial tracking system. Dose summations were performed to evaluate the safety of the reirradiation.
We identified 5 patients presenting peripheral lesions. All reirradiated lesions were locally controlled after a median follow-up of 11.1 months (6,7-12,2), while PFS at 6 months was 60% (n = 3). We did not notice any Grade 3 or more acute or late adverse event.
We observed encouraging short-term outcome of lung SBRT reirradiation in patients presenting isolated local relapse of an early-stage NSCLC. Further studies are necessary to confirm the safety and efficiency of this salvage treatment approach.
早期非小细胞肺癌(NSCLC)经肺部立体定向体部放疗(SBRT)后局部复发罕见,但由于手术选择有限,其治疗仍然是一项挑战。我们报告了一组5例患者的病例系列,这些患者在先前接受肺部SBRT后出现局部复发,接受了立体定向肺部挽救再照射治疗。
纳入的患者在先前SBRT治疗的至少50%等剂量线范围内出现孤立的原发性肺部复发。典型的再照射方案是在80%等剂量线下分8次给予60 Gy,由射波刀(Cyberknife®)使用同步(Synchrony®)基准跟踪系统进行照射。进行剂量累加以评估再照射的安全性。
我们确定了5例出现周围性病变的患者。在中位随访11.1个月(6.7 - 12.2个月)后,所有再照射的病变均得到局部控制,而6个月时的无进展生存期(PFS)为60%(n = 3)。我们未注意到任何3级或更高级别的急性或晚期不良事件。
我们观察到,对于早期NSCLC出现孤立局部复发的患者,肺部SBRT再照射的短期结果令人鼓舞。需要进一步研究以证实这种挽救治疗方法的安全性和有效性。