Salvage stereotactic body radiotherapy for post‑operative oligo‑recurrence of non‑small cell lung cancer: A single‑institution analysis of 59 patients

Aoki,Shuri; Yamashita,Hideomi; Takahashi,Wataru; Nawa,Kanabu; Ota,Takeshi; Imae,Toshikazu; Ozaki,Sho; Nozawa,Yuki; Nakajima,Jun; Sato,Masaaki; Anraku,Masaki; Nitadori,Junichi; Karasaki,Takahiro; Abe,Osamu; Nakagawa,Keiichi

doi:10.3892/ol.2020.11407

Salvage stereotactic body radiotherapy for post‑operative oligo‑recurrence of non‑small cell lung cancer: A single‑institution analysis of 59 patients

Authors:
- Shuri Aoki
- Hideomi Yamashita
- Wataru Takahashi
- Kanabu Nawa
- Takeshi Ota
- Toshikazu Imae
- Sho Ozaki
- Yuki Nozawa
- Jun Nakajima
- Masaaki Sato
- Masaki Anraku
- Junichi Nitadori
- Takahiro Karasaki
- Osamu Abe
- Keiichi Nakagawa
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Affiliations: Department of Radiology, University of Tokyo Hospital, Tokyo 113‑8655, Japan, Department of Thoracic Surgery, University of Tokyo Hospital, Tokyo 113‑8655, Japan
Published online on: February 17, 2020 https://doi.org/10.3892/ol.2020.11407
Pages: 2695-2704
Copyright: © Aoki et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

A standard treatment for patients with early‑stage non‑small cell lung cancer (NSCLC) who undergo surgery, and subsequently develop local failure or intrathoracic oligo‑recurrence, has not yet been established. The present study aimed to assess the feasibility of stereotactic body radiotherapy (SBRT) for this subgroup of patients. Consequently, a retrospective analysis was conducted of patients with NSCLC recurrence who were treated with SBRT, and previously underwent curative surgical resection between October 2011 and October 2016. Post‑SBRT survival [overall survival (OS); progression‑free survival (PFS); and local control (LC)] and toxicity were analyzed. Prognostic factors for OS were identified using univariate and multivariate analysis. A total of 52 patients and 59 tumors were analyzed. The median follow‑up time was 25 months (35 months for surviving patients), and median OS following salvage SBRT was 32 months. The 1‑ and 3‑year OS rates were 84.4 and 67.8%, respectively. 1‑ and 3‑year PFS rates were 80.8 and 58.7%, respectively. Only 4 patients (7.7%) developed local failure. Median LC was 71 months and 1‑ and 3‑year LC rate were 97.9 and 94.9%, respectively. A total of 4 patients experienced grade 3 or higher adverse events (AEs) and two experienced grade 5 AEs (pneumonitis and hemoptysis). Central tumor location and the possibility of re‑operation were independent prognostic factors for OS. The present study indicated that post‑operative salvage SBRT is a promising therapeutic option for patients with NSCLC with locoregional or intrathoracic oligo‑recurrence. We regard toxicity was also acceptable. However, further research is required on the appropriate selection of subjects, and stratification of the analysis by certain risk factors would increase the accuracy of the conclusions.

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