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Salvage proton beam therapy for locoregional recurrence of non-small cell lung cancer

Radiation Oncology Journal 2021년 39권 1호 p.24 ~ 32
신현주, 노재명, 표홍렬, 안용찬, 오동렬,
소속 상세정보
신현주 ( Shin Hyun-Ju ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Radiation Oncology
노재명 ( Noh Jae-Myoung ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Radiation Oncology
표홍렬 ( Pyo Hong-Ryull ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Radiation Oncology
안용찬 ( Ahn Yong-Chan ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Radiation Oncology
오동렬 ( Oh Dong-Ryul ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Radiation Oncology

Abstract


Purpose: This study aimed to evaluate the clinical outcomes and toxicities of salvage proton beam therapy (PBT) in patients with locoregional recurrent non-small cell lung cancer (NSCLC).

Materials and Methods: We retrospectively reviewed 53 patients who received salvage PBT for locoregionally recurrent NSCLC between January 2016 and December 2019. The median clinical target volume (CTV) was 71.2 cm3 (range, 13.3 to 1,200.7 cm3). The median prescribed dose was 64.0 cobalt gray equivalent (CGE) (range, 45.0 to 70.0 CGE). One-third of the patients (32.1%) received concurrent chemoradiotherapy (CCRT).

Results: The patients’ median age was 67 years (range, 44 to 86 years). The initial treatments were surgery in 31 (58.5%), definitive CCRT in 12 (22.6%), and definitive radiotherapy in 10 (18.9%) patients. The median disease-free interval (DFI) was 14 months (range, 3 to 112 months). Thirty-seven patients (69.8%) had a previous radiotherapy history. Among them, 18 patients (48.7%) had in-field recurrence. The median follow-up time after salvage PBT was 15.0 months (range, 3.5 to 49.3 months). During the follow-up period, 26 patients (49.1%) experienced disease progression: local in 13 (24.5%), regional in 14 (26.5%), and distant metastases in 15 (26.5%). The 2-year overall survival (OS) rate, local control rate, and progression-free survival rate were 79.2%, 68.2%, and 37.1%, respectively. Shorter DFI (≤12 months; p = 0.015) and larger CTV (>80 mL; p = 0.014) were associated with poor OS. Grade 3 toxicities occurred in 8 patients (15.1%): esophagitis in 2, dermatitis in 3, and pulmonary toxicities in 4.

Conclusion: Salvage PBT for locoregionally recurrent NSCLC was effective, and treatment-related toxicities were tolerable.

키워드

Non-small cell lung carcinoma; Locoregional neoplasm recurrence; Salvage therapy; Proton therapy

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