Abstract
Background: Re-irradiation is one of the treatment options for recurrence after initial radiotherapy for locally advanced lung cancer. However, the safety and efficacy of high-dose re-irradiation for recurrent lung cancer has yet to be completely understood. This study investigated the outcomes of high-dose re-irradiation for patients with recurrent lung cancer at our clinic.Methods: Data were collected from 36 patients with lung cancer (median age, 68 years) who received high-dose re-irradiation using intensity-modulated radiotherapy for locoregional recurrence after initial radiotherapy in the locally advanced stage. Histology findings showed that 11 (30.6%), 14 (38.9%), and 11 (30.6%) patients had adenocarcinoma, squamous cell carcinoma, and small cell carcinoma, respectively. The interval from initial radiotherapy to re-irradiation was 23.4 months. Local control (LC), progression-free survival (PFS), and overall survival (OS) were evaluated. Univariate and multivariate analyses were performed to identify prognostic factors, while late toxicities ≥grade3 were evaluated according to the CTCAE ver. 3.0.Results: The median follow-up was 14.6 months. The 1-year LC, PFS, and OS were 74.1%, 45.2%, and 78.7%, respectively. Multivariate analysis showed that histology was a significant prognostic factor for LC (p = 0.02), while histology (p = 0.04) and distant metastasis (p = 0.01) were significant prognostic factors for PFS. Grade 5 late toxicities occurred in 2 patients (5.6%) who exhibited esophageal perforation and bronchial perforation. No other ≥grade3 late toxicities occurred.Conclusion: High-dose re-irradiation for recurrent locally advanced lung cancer was effective and feasible. Lung adenocarcinoma might therefore be a good indication for re-irradiation.
Adenocarcinoma is a Favorable Prognostic Factor in High-Dose Re-Irradiation for Locally Advanced Lung Cancer
