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High Dose Involved Field Radiation Therapy as Salvage for Loco-Regional Recurrence of Non-Small Cell Lung Cancer

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Purpose: To determine the effectiveness of salvage radiation therapy (RT) in patients with loco-regional recurrences (LRR) following initial complete resection of non-small cell lung cancer (NSCLC) and assess prognostic factors affecting survivals. Materials and Methods: Between 1994 and 2007, 64 patients with LRR after surgery of NSCLC were treated with high dose RT alone (78.1%) or concurrent chemo-radiation therapy (CCRT, 21.9%) at Samsung Medical Center. Twenty-nine patients (45.3%) had local recurrence, 26 patients (40.6%) had regional recurrence and 9 patients (14.1%) had recurrence of both components. The median RT dose was 54 Gy (range, 44-66 Gy). The radiation target volume included the recurrent lesions only. Results: The median follow-up time from the start of RT in survivors was 32.0 months. The rates of in-field failure free survival, intra-thoracic failure free survival and extra-thoracic failure free survival at 2 years were 52.3%, 33.9% and 59.4%, respectively. The median survival after RT was 18.5 months, and 2-year overall survival (OS) rate was 47.9%. On both univariate and multivariate analysis, the interval from surgery till recurrence and CCRT were significant prognostic factors for OS. Conclusion: The current study demonstrates that involved field salvage RT is effective for LRR of NSCLC following surgery.

Abstract

Purpose: To determine the effectiveness of salvage radiation therapy (RT) in patients with loco-regional recurrences (LRR) following initial complete resection of non-small cell lung cancer (NSCLC) and assess prognostic factors affecting survivals. Materials and Methods: Between 1994 and 2007, 64 patients with LRR after surgery of NSCLC were treated with high dose RT alone (78.1%) or concurrent chemo-radiation therapy (CCRT, 21.9%) at Samsung Medical Center. Twenty-nine patients (45.3%) had local recurrence, 26 patients (40.6%) had regional recurrence and 9 patients (14.1%) had recurrence of both components. The median RT dose was 54 Gy (range, 44-66 Gy). The radiation target volume included the recurrent lesions only. Results: The median follow-up time from the start of RT in survivors was 32.0 months. The rates of in-field failure free survival, intra-thoracic failure free survival and extra-thoracic failure free survival at 2 years were 52.3%, 33.9% and 59.4%, respectively. The median survival after RT was 18.5 months, and 2-year overall survival (OS) rate was 47.9%. On both univariate and multivariate analysis, the interval from surgery till recurrence and CCRT were significant prognostic factors for OS. Conclusion: The current study demonstrates that involved field salvage RT is effective for LRR of NSCLC following surgery.

참고문헌 (36)

  1. Pearson FG, "Non-small cell lung cancer: role of surgery for stages I-III", Chest, 116(6 Suppl), pp.500~503 (1999)
  2. Matthews MJ, "Frequency of residual and metastatic tumor in patients undergoing curative surgical resection for lung cancer", Cancer Chemother Rep, 4, pp.63~67 (1973)
  3. Lafitte JJ, "Postresection irradiation for T2 N0 M0 non-small cell carcinoma: a prospective, randomized study", Ann Thorac Surg, 62, pp.830~834 (1996)
  4. al-Kattan K, "Disease recurrence after resection for stage I lung cancer", Eur J Cardiothorac Surg, 12, pp.380~384 (1997)
  5. Weisenburger TH, "Effects of postoperative mediastinal radiation on completely resected stage II and stage III epidermoid cancer of the lung. LCSG 773", Chest, 106(6 Suppl), pp.297~301 (1994)
  6. Kelsey CR, "Local recurrence following initial resection of NSCLC: salvage is possible with radiation therapy", Cancer J, 12, pp.283~288 (2006)
  7. Martini N, "Incidence of local recurrence and second primary tumors in resected stage I lung cancer", J Thorac Cardiovasc Surg, 109, pp.120~129 (1995)
  8. Gabler A, "Reoperation for bronchial carcinoma", Thorax, 35, pp.668~670 (1980)
  9. Watanabe Y, "Second surgical intervention for recurrent and second primary bronchogenic carcinomas", Scand J Thorac Cardiovasc Surg, 26, pp.73~78 (1992)
  10. Voltolini L, "Iterative surgical resections for local recurrent and second primary bronchogenic carcinoma", Eur J Cardiothorac Surg, 18, pp.529~534 (2000)
  11. Yamaoka N, "Reoperation for lung cancer: indications and operation methods in cardiopulmonary function", Kyobu Geka, 48, pp.18~23 (1995)
  12. Green N, "The clinical course and treatment results of patients with postresection locally recurrent lung cancer", Cancer, 42, pp.2478~2482 (1978)
  13. Kopelson G, "Radiation therapy for postoperative local-regionally recurrent lung cancer", Int J Radiat Oncol Biol Phys, 6, pp.1503~1506 (1980)
  14. Curran WJ Jr, "Should patients with post-resection locoregional recurrence of lung cancer receive aggressive therapy?", Int J Radiat Oncol Biol Phys, 24, pp.25~30 (1992)
  15. Shaw EG, "Locally recurrent non-small-cell lung cancer after complete surgical resection", Mayo Clin Proc, 67, pp.1129~1133 (1992)
  16. Yano T, "Local recurrence after complete resection for non-small-cell carcinoma of the lung. Significance of local control by radiation treatment", J Thorac Cardiovasc Surg, 107, pp.8~12 (1994)
  17. Leung J, "Survival following radiotherapy for post-surgical locoregional recurrence of non-small cell lung cancer", Lung Cancer, 13, pp.121~127 (1995)
  18. Emami B, "Radiation therapy for intrathoracic recurrence of non-small cell lung cancer", Am J Clin Oncol, 20, pp.46~50 (1997)
  19. Kagami Y, "Radiotherapy for locoregional recurrent tumors after resection of non-small cell lung cancer", Lung Cancer, 20, pp.31~35 (1998)
  20. Jeremic B, "External beam radiation therapy alone for loco-regional recurrence of non-small-cell lung cancer after complete resection", Lung Cancer, 23, pp.135~142 (1999)
  21. Tada T, "Non-small cell lung cancer : radiation therapy for locoregional recurrence after complete resection", Int J Clin Oncol, 10, pp.425~428 (2005)
  22. Cai XW, "Comparative survival in patients with postresection recurrent versus newly diagnosed non-small-cell lung cancer treated with radiotherapy", Int J Radiat Oncol Biol Phys, 76, pp.1100~1105 (2010)
  23. American Joint Committee on Cancer (AJCC), "AJCC Cancer Staging Manual. 6th ed", pp.167~184 (2002), Springer-Verlag
  24. Eisenhauer EA, "New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1)", Eur J Cancer, 45, pp.228~247 (2009)
  25. Kaplan EL, "Nonparametric estimation from incomplete observations", J Am Stat Assoc, 53, pp.457~481 (1958)
  26. Cerfolio RJ, "Improving the inaccuracies of clinical staging of patients with NSCLC: a prospective trial", Ann Thorac Surg, 80, pp.1207~1213 (2005)
  27. Kim BT, "Stage T1 non-small cell lung cancer: preoperative mediastinal nodal staging with integrated FDG PET", CT--a prospective study, 2006, pp.241, 501~509
  28. Lee BE, "Advances in positron emission tomography technology have increased the need for surgical staging in non-small cell lung cancer", J Thorac Cardiovasc Surg, 133, pp.746~752 (2007)
  29. Melek H, "Role of positron emission tomography in mediastinal lymphatic staging of non-small cell lung cancer", Eur J Cardiothorac Surg, 33, pp.294~299 (2008)
  30. Billé A, "Preoperative intrathoracic lymph node staging in patients with non-small-cell lung cancer: accuracy of integrated positron emission tomography and computed tomography", Eur J Cardiothorac Surg, 36, pp.440~445 (2009)
  31. Dosoretz DE, "Local control in medically inoperable lung cancer: an analysis of its importance in outcome and factors determining the probability of tumor eradication", Int J Radiat Oncol Biol Phys, 27, pp.507~516 (1993)
  32. Rosenzweig KE, "Elective nodal irradiation in the treatment of non-small-cell lung cancer with three-dimensional conformal radiation therapy", Int J Radiat Oncol Biol Phys, 50, pp.681~685 (2001)
  33. Jeremic B, "External beam radiation therapy for bronchial stump recurrence of non-small-cell lung cancer after complete resection", Radiother Oncol, 64, pp.251~257 (2002)
  34. Law MR, "Value of radiotherapy for tumour on the bronchial stump after resection for bronchial carcinoma", Thorax, 37, pp.496~499 (1982)
  35. Rea F, "Prognostic significance of main bronchial lymph nodes involvement in non-small cell lung carcinoma: N1 or N2?", Lung Cancer, 45, pp.215~220 (2004)
  36. Zheng H, "Re-appraisal of N2 disease by lymphatic drainage pattern for non-small-cell lung cancers: by terms of nodal stations, zones, chains, and a composite", Lung Cancer, 74, pp.497~503 (2011)

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