Mauro Geovanne Pedro, Pereira Maria Luiza Alves José Ferioli, de Oliveira Costa Mauricio José, Carvalho Heloisa A
Radiology and Oncology, University of Sao Paulo Hospital of Clinics, Sao Paulo, Brazil.
Radiotherapy, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil.
Rep Pract Oncol Radiother. 2025 Mar 21;30(1):27-33. doi: 10.5603/rpor.104385. eCollection 2025.
This study intends to analyze the feasibility and the outcomes of stereotactic body radiotherapy (SBRT) as a salvage treatment for lung cancer after primary surgery and compare them with the results of SBRT as the first treatment option.
Retrospective analysis of early-stage non-small cell lung cancer (NSCLC) treated with SBRT, either as a primary treatment or as salvage treatment after primary surgery.
From January 2017 to January 2022, 68 patients were analyzed. 80% were 65 years-old or above. Seven (10%) underwent SBRT as a salvage treatment after primary surgery. Most lesions treated with primary SBRT were peripheral (n = 33; 54.1%), opposed to the salvage group, where 71.4% were central lesions (n = 5). Patients who had previous surgery presented with lower forced expiratory volume in 1 second (FEV1) (p = 0.006). Median time between surgery and salvage SBRT was 35.4 months. Median follow-up was 29.3 months; median overall survival (OS) at 2 years and 3 years was, respectively, 73.5% and 67.6% (median 52.5 months), with no difference between groups. Median local, regional, and distant progression free survivals were not reached. Local control was 94.1% at 2 years and 92.6% at 3 years. Only 5 (8.2%) patients presented late grade 3-4 pneumonitis, and one, grade 5 (fatal), all in the primary SBRT group.
SBRT as salvage after primary surgery is feasible and seems to be safe. Outcomes are expected to be equivalent to those of the patients submitted to primary SBRT.
本研究旨在分析立体定向体部放疗（SBRT）作为肺癌初次手术后挽救治疗的可行性和结果，并将其与SBRT作为首选治疗方案的结果进行比较。
对接受SBRT治疗的早期非小细胞肺癌（NSCLC）进行回顾性分析，SBRT作为主要治疗或初次手术后的挽救治疗。
2017年1月至2022年1月，共分析了68例患者。80%为65岁及以上。7例（10%）在初次手术后接受SBRT作为挽救治疗。大多数接受主要SBRT治疗的病变位于外周（n = 33；54.1%），而挽救治疗组中71.4%为中央病变（n = 5）。既往有手术史的患者1秒用力呼气量（FEV1）较低（p = 0.006）。手术与挽救性SBRT之间的中位时间为35.4个月。中位随访时间为29.3个月；2年和3年的中位总生存期（OS）分别为73.5%和67.6%（中位52.5个月），两组之间无差异。局部、区域和远处无进展生存期的中位数未达到。2年局部控制率为94.1%，3年为92.6%。仅5例（8.2%）患者出现3-4级晚期肺炎，1例出现5级（致命）肺炎，均在主要SBRT组。
初次手术后SBRT作为挽救治疗是可行的，且似乎是安全的。预期结果与接受主要SBRT治疗的患者相当。
