Stereotactic lung reirradiation for local relapse: A case series

Rémy Kinj; Alessio Casutt; Alexander Bennassi; Hasna Bouchaab; Véronique Vallet; Alban Lovis; Mahmut Ozsahin

doi:10.1016/j.ctro.2021.03.007

Stereotactic lung reirradiation for local relapse: A case series

Clin Transl Radiat Oncol. 2021 Apr 5:28:85-87. doi: 10.1016/j.ctro.2021.03.007. eCollection 2021 May.

Authors

Rémy Kinj¹, Alessio Casutt², Alexander Bennassi¹, Hasna Bouchaab³, Véronique Vallet⁴, Alban Lovis², Mahmut Ozsahin¹

Affiliations

¹ Department of Radiation Oncology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
² Department of Pulmonology, Lausanne University Hospital, Lausanne, Switzerland.
³ Department of Medical Oncology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
⁴ Institute of Radiation Physics, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.

Abstract

Introduction: 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.

Material and methods: 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.

Results: 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.

Conclusion: 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.

Keywords: Lung cancer; Lung reirradiation; SBRT reirradiation; Stereotactic treatment.