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S. Hahn
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P2.03 - Poster Session/ Treatment of Locoregional Disease – NSCLC (ID 213)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Locoregional Disease – NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.03-018 - Tolerability of Re-Irradiation for Locally Recurrent Lung Cancer (ID 836)
09:30 - 09:30 | Author(s): S. Hahn
- Abstract
Background:
Treatment of locally recurrent of lung cancer in the setting of prior radiotherapy is a therapeutic challenge, particularly when treating with curative intent.
Methods:
Retrospective review of lung cancer patients treated with 2+ courses of modern radiotherapy, which included image guidance (IGRT). Repeat irradiation was defined as an overlap of the gross tumor volume (GTV) in all treatment courses.
Results:
Thirty-three patients, 25 non-small cell and 8 small cell, received re-irradiation including one patient treated thrice. Thirteen patients initially had early disease (6 stage I, 7 II), and 20 patients had locally advanced or advanced disease. Median interval between treatments was 15 months (range 5 months – 13 years 3 months). 16 patients received concurrent chemotherapy with both courses. 13 additional patients received chemotherapy concurrently during one of the courses of treatment. Seven patients were treated with stereotactic body radiation therapy for one of the courses. 24 patients were treated to the mediastinum twice and 9 additional patients received mediastinal treatment during one of the courses. Cumulative prescribed doses ranged up to 14,000 cGy and 18 patients received > 10,000 cGy. Maximum absolute dose to the lung was 14,000 cGy and to the mediastinum was 14,500 cGy. Ten patients remain alive with a median follow up of 20 months (range 9 months – 36 months). Treatment was generally well tolerated with esophagitis <= grade 3 common during the first or second course of therapy (16% and 24% respectively). Fatigue was noted in 18% of patients following the 2[nd] course of radiotherapy and only 3% during the initial course but this may be related to concurrent chemotherapy. One patient developed grade 4 dyspnea possibly related to repeat irradiation, though it was the 5[th] overall course of radiotherapy to the chest. Grade 5 toxicity was not observed and severe late effects were also not reported.
Conclusion:
Re-irradiation, even when concurrent chemotherapy is utilized, appears to be well tolerated with modern treatment planning including the use of IGRT. Further follow-up is necessary to better define local control, overall survival, and potential late toxicity. Additional studies are warranted to further investigate the long-term impact of patients treated more than once to the same region.
