PMID- 33083662
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220417
IS  - 2452-1094 (Print)
IS  - 2452-1094 (Electronic)
IS  - 2452-1094 (Linking)
VI  - 5
IP  - 5
DP  - 2020 Sep-Oct
TI  - Repeat Thoracic Stereotactic Body Radiation Therapy (SBRT) for Nonsmall Cell Lung 
      Cancer: Long-Term Outcomes, Toxicity, and Dosimetric Considerations.
PG  - 984-993
LID - 10.1016/j.adro.2020.06.006 [doi]
AB  - PURPOSE: Lung reirradiation for nonsmall cell lung cancer (NSCLC) is common for 
      either recurrent disease or new primary cancer. Dose volume tolerance of the lung 
      after multiple courses of radiation therapy (RT) is unknown. We review our 
      experience with lung reirradiation for patients with NSCLC in a single community 
      setting using stereotactic body radiation therapy (SBRT) to report lung 
      cumulative doses, survival, and toxicity. METHODS AND MATERIALS: Forty-four 
      patients who received at least 2 curative courses of lung RT with the second 
      course delivered between January 2012 and December 2017 were eligible. All 
      patients had NSCLC and were treated with SBRT for reirradiation. Cumulative lung 
      dose volume histograms for all courses were generated, summated, and converted 
      into cumulative equivalent dose in 2 Gy fractions (EQD2). Actuarial overall 
      survival (OS), local control, and toxicity is reported, including a subset of 
      patients who received more than 2 courses of SBRT. RESULTS: Median age of the 
      group was 71 years (range, 51-87). Median survival of the entire group from 
      diagnosis, first, and second courses of RT was 3.94, 3.03, and 2.03 years. 
      Three-year actuarial OS for the entire group was 34.1% from second course of RT. 
      The mean EQD2 Gy(3) mean lung dose for all courses was 12.35 Gy (range, 
      2.7-26.52). The mean EQD2 Gy(3) V5Gy, V10Gy, V20Gy, V30Gy, and V40Gy were 40.9%, 
      25.5%, 14.7%, 10.2%, and 7.7%. Six-year actuarial freedom from grade >/=3 
      complications was 86.3%. The rate of grade >/=3 lung toxicity was 4.5% (2 of 44). 
      Other late toxicities included grade 3 recurrent laryngeal nerve damage (n = 1) 
      and grade 3 chest wall pain/rib fracture (n = 1). Overall, 32% of patients had 
      more than 2 courses of RT to the lung (range, 3-7). CONCLUSIONS: Long-term OS is 
      possible with multiple RT courses to the lung for NSCLC with low toxicity.
CI  - (c) 2020 The Author(s).
FAU - Ricco, Anthony
AU  - Ricco A
AD  - Department of Radiation Oncology, Virginia Commonwealth University, Richmond, 
      Virginia.
FAU - Barlow, Sara
AU  - Barlow S
AD  - Drexel College of Medicine, Philadelphia, Pennsylvania.
FAU - Feng, Jing
AU  - Feng J
AD  - Philadelphia CyberKnife, Crozer-Keystone Health System, Havertown, Pennsylvania.
FAU - Jacob, Janson
AU  - Jacob J
AD  - Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan.
FAU - Lozano, Alicia
AU  - Lozano A
AD  - Virginia Polytechnic Institute and State University, Blacksburg, Virginia.
FAU - Hanlon, Alexandra
AU  - Hanlon A
AD  - Virginia Polytechnic Institute and State University, Blacksburg, Virginia.
FAU - Arrigo, Stephen
AU  - Arrigo S
AD  - Philadelphia CyberKnife, Crozer-Keystone Health System, Havertown, Pennsylvania.
FAU - Obayomi-Davies, Olusola
AU  - Obayomi-Davies O
AD  - Philadelphia CyberKnife, Crozer-Keystone Health System, Havertown, Pennsylvania.
FAU - Lamond, John
AU  - Lamond J
AD  - Philadelphia CyberKnife, Crozer-Keystone Health System, Havertown, Pennsylvania.
FAU - Yang, Jun
AU  - Yang J
AD  - Philadelphia CyberKnife, Crozer-Keystone Health System, Havertown, Pennsylvania.
FAU - Lanciano, Rachelle
AU  - Lanciano R
AD  - Philadelphia CyberKnife, Crozer-Keystone Health System, Havertown, Pennsylvania.
LA  - eng
PT  - Journal Article
DEP - 20200625
PL  - United States
TA  - Adv Radiat Oncol
JT  - Advances in radiation oncology
JID - 101677247
PMC - PMC7557141
EDAT- 2020/10/22 06:00
MHDA- 2020/10/22 06:01
PMCR- 2020/06/25
CRDT- 2020/10/21 06:05
PHST- 2019/12/16 00:00 [received]
PHST- 2020/05/24 00:00 [revised]
PHST- 2020/06/10 00:00 [accepted]
PHST- 2020/10/21 06:05 [entrez]
PHST- 2020/10/22 06:00 [pubmed]
PHST- 2020/10/22 06:01 [medline]
PHST- 2020/06/25 00:00 [pmc-release]
AID - S2452-1094(20)30155-X [pii]
AID - 10.1016/j.adro.2020.06.006 [doi]
PST - epublish
SO  - Adv Radiat Oncol. 2020 Jun 25;5(5):984-993. doi: 10.1016/j.adro.2020.06.006. 
      eCollection 2020 Sep-Oct.