Format

Send to

Choose Destination
Radiother Oncol. 2013 Oct;109(1):38-44. doi: 10.1016/j.radonc.2013.08.014. Epub 2013 Sep 7.

Feasibility of proton beam therapy for reirradiation of locoregionally recurrent non-small cell lung cancer.

Author information

1
Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States.

Abstract

BACKGROUND AND PURPOSE:

Options are limited for patients with intrathoracic recurrence of non-small cell lung cancer (NSCLC) who previously received radiation. We report our 5-year experience with the toxicity and efficacy of proton beam therapy (PBT) for reirradiation.

MATERIALS AND METHODS:

Thirty-three patients underwent PBT reirradiation for intrathoracic recurrent NSCLC at a single institution. All patients had had RT for NSCLC (median initial dose 63 Gy in 33 fractions), with median interval to reirradiation of 36 months. Median reirradiation dose was 66 Gy (RBE) in 32 fractions. Toxicity was scored with CTCAE v4.0, and survival outcomes were estimated using Kaplan-Meier.

RESULTS:

Thirty-one patients (94%) completed reirradiation. At a median 11 months' follow-up, 1-year rates of overall survival, progression-free survival, locoregional control, and distant metastasis-free survival were 47%, 28%, 54%, and 39%. Rates of severe (grade ≥3) toxicity were 9% esophageal, 21% pulmonary; 1 patient had grade 4 esophagitis, and 2 had grade 4 pulmonary toxicity. Nine patients experienced a second in-field failure.

CONCLUSIONS:

PBT is an option for treating recurrent NSCLC. However, the rates of locoregional recurrence and distant metastasis are high and the potential for toxicity significant. The risks and benefits of PBT must be carefully weighed in each case.

KEYWORDS:

Non small cell lung cancer; Proton beam radiotherapy; Reirradiation

PMID:
24016675
DOI:
10.1016/j.radonc.2013.08.014
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center