Stereotactic body radiation therapy in the treatment of multiple primary lung cancers

Background and purpose: Patients with multiple primary lung cancers (MPLC) present a therapeutic dilemma, particularly when they are at high risk for surgical resection. We evaluated the role of stereotactic body radiation therapy (SBRT) in the treatment of MPLC. Materials and methods: A prospective...

Full description

Saved in:
Bibliographic Details
Main Authors: Kimberly M. Creach, Jeffrey D. Bradley, Pawinee Mahasittiwat, Clifford G. Robinson
Other Authors: Washington University School of Medicine in St. Louis
Format: Article
Published: 2018
Subjects:
Online Access:https://repository.li.mahidol.ac.th/handle/123456789/14739
Tags: Add Tag
No Tags, Be the first to tag this record!
Institution: Mahidol University
id th-mahidol.14739
record_format dspace
spelling th-mahidol.147392018-06-11T12:08:25Z Stereotactic body radiation therapy in the treatment of multiple primary lung cancers Kimberly M. Creach Jeffrey D. Bradley Pawinee Mahasittiwat Clifford G. Robinson Washington University School of Medicine in St. Louis Mahidol University Medicine Background and purpose: Patients with multiple primary lung cancers (MPLC) present a therapeutic dilemma, particularly when they are at high risk for surgical resection. We evaluated the role of stereotactic body radiation therapy (SBRT) in the treatment of MPLC. Materials and methods: A prospective thoracic SBRT registry was explored for patients with either synchronous or metachronous MPLC treated with SBRT for one or both of their tumors. Sixty-three patients were identified and clinical data were analyzed. Results: Fifteen patients had synchronous lesions and 48 patients had metachronous lesions. Seventy-six lesions were treated with SBRT. Median follow-up was 24 months for living patients. Median progression-free survival (PFS) and overall survival (OS) for the entire cohort was 15.5 and 20 months, respectively. Patients with metachronous MPLC had a significantly higher 2 year PFS (53.3% vs. 0%, p = 0.0466) compared to patients with synchronous MPLC. Likewise, 2 year OS was also superior for patients with metachronous versus synchronous MPLC (68.1% vs. 27.5%, p = 0.0014). Six tumors (7.9%) recurred within the radiation field. There were no grade ≥3 toxicities. Conclusions: SBRT for patients with MPLC appears to be a safe and effective local treatment alternative to surgery, particularly for medically inoperable patients. Patients with metachronous MPLC have encouraging survival rates, and thus local therapy appears justified. However, patients with synchronous MPLC have poor OS and PFS despite having excellent local control, and thus the utility of local therapy in this population requires further study. © 2011 Elsevier Ireland Ltd. All rights reserved. 2018-06-11T05:08:25Z 2018-06-11T05:08:25Z 2012-07-01 Article Radiotherapy and Oncology. Vol.104, No.1 (2012), 19-22 10.1016/j.radonc.2011.12.005 18790887 01678140 2-s2.0-84863190969 https://repository.li.mahidol.ac.th/handle/123456789/14739 Mahidol University SCOPUS https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84863190969&origin=inward
institution Mahidol University
building Mahidol University Library
continent Asia
country Thailand
Thailand
content_provider Mahidol University Library
collection Mahidol University Institutional Repository
topic Medicine
spellingShingle Medicine
Kimberly M. Creach
Jeffrey D. Bradley
Pawinee Mahasittiwat
Clifford G. Robinson
Stereotactic body radiation therapy in the treatment of multiple primary lung cancers
description Background and purpose: Patients with multiple primary lung cancers (MPLC) present a therapeutic dilemma, particularly when they are at high risk for surgical resection. We evaluated the role of stereotactic body radiation therapy (SBRT) in the treatment of MPLC. Materials and methods: A prospective thoracic SBRT registry was explored for patients with either synchronous or metachronous MPLC treated with SBRT for one or both of their tumors. Sixty-three patients were identified and clinical data were analyzed. Results: Fifteen patients had synchronous lesions and 48 patients had metachronous lesions. Seventy-six lesions were treated with SBRT. Median follow-up was 24 months for living patients. Median progression-free survival (PFS) and overall survival (OS) for the entire cohort was 15.5 and 20 months, respectively. Patients with metachronous MPLC had a significantly higher 2 year PFS (53.3% vs. 0%, p = 0.0466) compared to patients with synchronous MPLC. Likewise, 2 year OS was also superior for patients with metachronous versus synchronous MPLC (68.1% vs. 27.5%, p = 0.0014). Six tumors (7.9%) recurred within the radiation field. There were no grade ≥3 toxicities. Conclusions: SBRT for patients with MPLC appears to be a safe and effective local treatment alternative to surgery, particularly for medically inoperable patients. Patients with metachronous MPLC have encouraging survival rates, and thus local therapy appears justified. However, patients with synchronous MPLC have poor OS and PFS despite having excellent local control, and thus the utility of local therapy in this population requires further study. © 2011 Elsevier Ireland Ltd. All rights reserved.
author2 Washington University School of Medicine in St. Louis
author_facet Washington University School of Medicine in St. Louis
Kimberly M. Creach
Jeffrey D. Bradley
Pawinee Mahasittiwat
Clifford G. Robinson
format Article
author Kimberly M. Creach
Jeffrey D. Bradley
Pawinee Mahasittiwat
Clifford G. Robinson
author_sort Kimberly M. Creach
title Stereotactic body radiation therapy in the treatment of multiple primary lung cancers
title_short Stereotactic body radiation therapy in the treatment of multiple primary lung cancers
title_full Stereotactic body radiation therapy in the treatment of multiple primary lung cancers
title_fullStr Stereotactic body radiation therapy in the treatment of multiple primary lung cancers
title_full_unstemmed Stereotactic body radiation therapy in the treatment of multiple primary lung cancers
title_sort stereotactic body radiation therapy in the treatment of multiple primary lung cancers
publishDate 2018
url https://repository.li.mahidol.ac.th/handle/123456789/14739
_version_ 1763493077225308160