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Metachronous NSCLC in previously irradiated patients: is re-irradiation with SBRT a good option as definitive treatment?

Published online by Cambridge University Press:  23 December 2019

Corrado Spatola ,
Roberto Massimo Milazzotto Open the ORCID record for Roberto Massimo Milazzotto [Opens in a new window] ,
Alessandra Tocco ,
Luigi Raffaele ,
Viviana La Monaca ,
Vincenzo Salamone ,
Pietro Milone ,
Pietro Valerio Foti ,
Stefano Pergolizzi  and
Antonio Basile
...Show all authors
Corrado Spatola
Affiliation:
Department of Radiodiagnostica e Radioterapia Oncologica, Azienda Ospedaliero Universitaria Policlinico Vittorio Emanuele Catania, Catania, Italy
Roberto Massimo Milazzotto*
Affiliation:
Department of Radiodiagnostica e Radioterapia Oncologica, Azienda Ospedaliero Universitaria Policlinico Vittorio Emanuele Catania, Catania, Italy
Alessandra Tocco
Affiliation:
Department of Radiodiagnostica e Radioterapia Oncologica, Azienda Ospedaliero Universitaria Policlinico Vittorio Emanuele Catania, Catania, Italy
Luigi Raffaele
Affiliation:
Department of Radiodiagnostica e Radioterapia Oncologica, Azienda Ospedaliero Universitaria Policlinico Vittorio Emanuele Catania, Catania, Italy
Viviana La Monaca
Affiliation:
Department of Radiodiagnostica e Radioterapia Oncologica, Azienda Ospedaliero Universitaria Policlinico Vittorio Emanuele Catania, Catania, Italy
Vincenzo Salamone
Affiliation:
Department of Radiodiagnostica e Radioterapia Oncologica, Azienda Ospedaliero Universitaria Policlinico Vittorio Emanuele Catania, Catania, Italy
Pietro Milone
Affiliation:
Department of Radiodiagnostica e Radioterapia Oncologica, Azienda Ospedaliero Universitaria Policlinico Vittorio Emanuele Catania, Catania, Italy
Pietro Valerio Foti
Affiliation:
Department of Radiodiagnostica e Radioterapia Oncologica, Azienda Ospedaliero Universitaria Policlinico Vittorio Emanuele Catania, Catania, Italy
Stefano Pergolizzi
Affiliation:
Department of Radiotherapy, Azienda Ospedaliera Universitaria Policlinico of Messina, Messina, Italy
Antonio Basile
Affiliation:
Department of Radiodiagnostica e Radioterapia Oncologica, Azienda Ospedaliero Universitaria Policlinico Vittorio Emanuele Catania, Catania, Italy
Giuseppe Privitera
Affiliation:
Department of Radiodiagnostica e Radioterapia Oncologica, Azienda Ospedaliero Universitaria Policlinico Vittorio Emanuele Catania, Catania, Italy
*
Author for correspondence: Roberto Massimo Milazzotto, Azienda Ospedaliero Universitaria Policlinico Vittorio Emanuele Catania, Via Santa Sofia n. 78, Catania 95123, Italy. E-mail: robertomilazz@hotmail.it
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Abstract

Aim:

Treatment of metachronous second primary non-small cell lung cancer (NSCLC) in patients already treated with definitive radiotherapy is a matter of debate, since most patients are excluded from surgical treatment, which remains a therapeutic standard for patients with isolated lung masses. Salvage chemotherapy or immunotherapy alone offers a low probability of disease control. The option of re-irradiation often remains the only viable, but the risks of severe acute or late toxicities affecting the surrounding normal tissues make this a real clinical challenge.

Materials and methods:

From January 2015 to April 2018, five patients (male/female: 4/1; age 54–81 years, median 68) with previously irradiated NSCLC presented with a second primary lung tumour.

Results:

A partial response was seen in four patients, one complete responses in the fifth. The toxicity was low: two patients experienced a grade 2 asymptomatic radiation pneumonitis after 6 and 12 months from the end of stereotactic body radiation therapy, resolved with cortisone therapy. No acute or late oesophageal or cardiac toxicity was found.

Findings:

In this work, we present our initial experience about the use of stereotactic radiotherapy technique in already irradiated patients. We reported a local disease control in all cases with an acceptable toxicity.

Keywords

lung cancernon-small cellNSCLCre-irradiationSBRTSRTstereotactic radiotherapy
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 19 , Issue 3 , September 2020 , pp. 215 - 218
Copyright
© Cambridge University Press 2019

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