Is hypofractionated reirradiation effective after symptomatic local recurrence in non-small cell lung cancer?


Çetingöz R., Kentli S., Ataman Ö., Kinay M.

Journal of B.U.ON., vol.5, no.4, pp.421-425, 2000 (Scopus) identifier

  • Publication Type: Article / Article
  • Volume: 5 Issue: 4
  • Publication Date: 2000
  • Journal Name: Journal of B.U.ON.
  • Journal Indexes: Scopus
  • Page Numbers: pp.421-425
  • Keywords: Hypofractionated reirradiation, Non-small cell lung cancer, Radiotherapy, Recurrence, Symptom relief
  • Dokuz Eylül University Affiliated: Yes

Abstract

Purpose: To evaluate retrospectively the treatment results of recurrent non-small cell lung cancer (NSCLC) patients treated with second-line hypofractionated radiotherapy. Patients and methods: Twenty-five patients with locally advanced NSCLC and symptomatic local recurrence after primary hypofractionated radiotherapy, were retreated with second-line hypofractionated irradiation between July 1991 and April 1999. Maximum effort was undertaken to protect normal lung tissue with careful simulations, limited safety margins and customized blocking. The spinal cord was excluded with parallelly opposed isocentric oblique fields in central tumors. Total doses ranging between 2000-3000 cGy (median 2500 cGy) were delivered in 5-15 fractions. Nine patients were administered systemic chemotherapy (CT) before reirradiation. Survival analysis and subjective response rates were evaluated according to starting dates of both radiotherapy courses and clinical improvement in symptomatology, respectively. Results: Median follow-up time was 48 weeks (range 13-121 weeks). The mean time-interval between the two radiotherapy courses was 32 weeks (range 4-65 weeks). Overall improvement in symptomatology was found to be 72.7% (32 out of 44 patients), with a complete response rate of 38.6% (17 out of 44 patients). Hemoptysis was the best palliated symptom. Overall and post-reirradiation median survival times were found to be 48 and 17 weeks, respectively. The majority of patients were regularly followed-up until death. No Radiation Therapy Oncology Group (RTOG) toxicity grades III-IV were registered. Conclusion: Even though this is a retrospective study containing a small number of patients, hypofractionated reirradiation appears to be safe and effective in palliating symptoms related to NSCLC and prolonged survival can be offered.