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Research ArticleClinical Studies

Repeated Stereotactic Body Radiotherapy for Lung Malignancies: Toxicity Can Be Reduced by Sparing Lung Irradiation

SHOU WATANABE, HIDEYA YAMAZAKI, TAKYUA KIMOTO, GEN SUZUKI and KEI YAMADA
Anticancer Research May 2022, 42 (5) 2701-2709; DOI: https://doi.org/10.21873/anticanres.15748
SHOU WATANABE
1Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan;
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  • For correspondence: swta@koto.kpu-m.ac.jp
HIDEYA YAMAZAKI
1Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan;
2CyberKnife Center, Soseikai Clinic, Kyoto, Japan
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TAKYUA KIMOTO
1Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan;
2CyberKnife Center, Soseikai Clinic, Kyoto, Japan
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GEN SUZUKI
1Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan;
2CyberKnife Center, Soseikai Clinic, Kyoto, Japan
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KEI YAMADA
1Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan;
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Abstract

Background/Aim: Evidence on the use of repeated stereotactic body radiotherapy (SBRT) is limited. We investigated the efficacy of repeated SBRT and predictors of lung toxicity. Patients and Methods: We reviewed 20 patients (27 lesions) with primary or metastatic lung cancer who underwent repeated SBRT with CyberKnife®. We generated a composite plan for dosimetric analysis based on equivalent doses in 2.0-Gy fractions (α/β=3). Predictors of Grade 2+ radiation pneumonitis (RP) were examined. Results: The median follow-up duration was 18.0 months. The 1-year and 2-year local control were both 95.2%. Five patients (25%) developed Grade 2+ RP, including a Grade 5 RP. The Grade 2+ RP group showed higher composite mean lung dose (MLD) and lower lung volumes spared from 5-20 Gy (VS5-VS20). Conclusion: Repeated SBRT with CyberKnife® showed favorable local control, but a high rate of Grade 2+ RP. Accumulated MLD and VS5-VS20 may predict RP.

Key Words:
  • Stereotactic body radiotherapy
  • primary lung cancer
  • oligometastasis
  • re-irradiation
  • radiation pneumonitis
  • Received March 8, 2022.
  • Revision received March 26, 2022.
  • Accepted March 28, 2022.
  • Copyright © 2022 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.
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Anticancer Research: 42 (5)
Anticancer Research
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May 2022
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Repeated Stereotactic Body Radiotherapy for Lung Malignancies: Toxicity Can Be Reduced by Sparing Lung Irradiation
SHOU WATANABE, HIDEYA YAMAZAKI, TAKYUA KIMOTO, GEN SUZUKI, KEI YAMADA
Anticancer Research May 2022, 42 (5) 2701-2709; DOI: 10.21873/anticanres.15748

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Repeated Stereotactic Body Radiotherapy for Lung Malignancies: Toxicity Can Be Reduced by Sparing Lung Irradiation
SHOU WATANABE, HIDEYA YAMAZAKI, TAKYUA KIMOTO, GEN SUZUKI, KEI YAMADA
Anticancer Research May 2022, 42 (5) 2701-2709; DOI: 10.21873/anticanres.15748
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Keywords

  • Stereotactic body radiotherapy
  • primary lung cancer
  • oligometastasis
  • re-irradiation
  • radiation pneumonitis
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