Document Detail


Reirradiation for locoregionally recurrent lung cancer: outcomes in small cell and non-small cell lung carcinoma.
MedLine Citation:
PMID:  23357968     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To our knowledge this is the largest report analyzing outcomes for re-irradiation (reRT) for locoregionally recurrent lung cancer, and the first to assess thoracic reRT outcomes in patients with small cell lung cancer (SCLC).
METHODS: Forty-eight patients (11 SCLC, 37 non-small cell lung cancer [NSCLC]) receiving reRT to the thorax were identified; 44 (92%) received reRT by intensity-modulated radiotherapy. Palliative responses, survival outcomes, and prognostic factors were analyzed.
RESULTS: NSCLC patients received a median of 30 Gy in a median of 10 fractions, whereas SCLC patients received a median of 37.5 Gy in a median of 15 fractions. Median survival for the entire cohort from reRT was 4.2 months. Median survival for NSCLC patients was 5.1 months, versus 3.1 months for the SCLC patients (P=0.15). In NSCLC patients, multivariate analysis demonstrated that Karnofsky performance status≥80 and higher radiation dose were associated with improved survival following reRT, and 75% of patients with symptoms experienced palliative benefit. In SCLC, 4 patients treated with the intent of life prolongation for radiographic recurrence had a median survival of 11.7 months. However, acute toxicities and new disease symptoms limited the duration of palliative benefit in the 7 symptomatic SCLC patients to 0.5 months.
CONCLUSIONS: ReRT to the thorax for locoregionally recurrent NSCLC can provide palliative benefit, and a small subset of patients may experience long-term survival. Select SCLC patients may experience meaningful survival prolongation after reRT, but reRT for patients with symptomatic recurrence and/or extrathoracic disease did not offer meaningful survival or durable symptom benefit.
Authors:
Tim J Kruser; Bradley P McCabe; Minesh P Mehta; Deepak Khuntia; Toby C Campbell; Heather M Geye; George M Cannon
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of clinical oncology     Volume:  37     ISSN:  1537-453X     ISO Abbreviation:  Am. J. Clin. Oncol.     Publication Date:  2014 Feb 
Date Detail:
Created Date:  2014-01-23     Completed Date:  2014-03-17     Revised Date:  2014-03-20    
Medline Journal Info:
Nlm Unique ID:  8207754     Medline TA:  Am J Clin Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  70-6     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Carcinoma, Non-Small-Cell Lung / mortality,  pathology,  radiotherapy*
Carcinoma, Small Cell / mortality,  pathology,  radiotherapy*
Dose Fractionation
Female
Humans
Kaplan-Meier Estimate
Karnofsky Performance Status
Lung Neoplasms / mortality,  pathology,  radiotherapy*
Male
Middle Aged
Multivariate Analysis
Neoplasm Recurrence, Local / mortality,  radiotherapy*
Proportional Hazards Models
Retreatment
Treatment Outcome
Grant Support
ID/Acronym/Agency:
P30 CA014520/CA/NCI NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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