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.

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

Spatola C.;Raffaele L.;La Monaca V.;Milone P.;Foti P. V.;Basile A.;
2020-01-01

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.
lung cancer
non-small cell
NSCLC
re-irradiation
SBRT
SRT
stereotactic radiotherapy
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/20.500.11769/493474
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