12â¯× 6â¯Gy stereotactic radiotherapy for lung tumors. Is there a difference in response between lung metastases and primary bronchial carcinoma?
Strahlenther Onkol
; 198(2): 110-122, 2022 Feb.
Article
em En
| MEDLINE
| ID: mdl-34255094
ABSTRACT
PURPOSE:
The aim of this study was to evaluate the safety and long-term tumor control after stereotactic radiotherapy (SRT) with 12â¯× 6â¯Gy of patients with primary bronchial carcinoma (BC) or with pulmonary metastases (MET) of various solid tumors. Local progression-free survival (LPFS), progression-free survival (PFS), overall survival (OS), and prognostic factors were compared.METHODS:
Between May 2012 and January 2020, 168 patients with 206 pulmonary lesions (170 MET and 36 primary BC) were treated with 12â¯× 6â¯Gy (BED10 116â¯Gy). The irradiated pulmonary MET were from the following cancers 47 (27.6%) head and neck, 37 (21.8%) rectum or colon, 30 (17.6%) bronchial, 13 (7.6%) malignant melanoma, 9 (5.3%) esophageal, 9 (5.3%) sarcoma, and 25 (14.8%) other.RESULTS:
The median follow-up was 16.26 months (range 0.46-89.34) for BC and 19.18 months (0.89-91.11) for MET. Survival rates at 3 years were OS 43% for BC and 35% for MET; LPFS BC 96% and MET 85%; PFS BC 35% and MET 29%. The most frequently observed grade 3 adverse events (AEs) were pneumonitis (5.9% BC, 4.8% MET), pulmonary fibrosis (2.9% BC, 4% MET), and pulmonary embolism (2.9% BC, 0.8% MET). The favorable prognostic effects on overall survival of patients with MET were female gender (log-rank pâ¯< 0.001), no systemic progression (log-rank; pâ¯= 0.048, multivariate COX regression pâ¯= 0.039), and malignant melanoma histology (log-rank; pâ¯= 0.015, multivariate COX regression pâ¯= 0.020). For patients with BC, it was tumor location within the lower lobe (vs. upper lobe, log-rank pâ¯= 0.027). LPFS of patients with metastatic disease was beneficially influenced by female gender (log-rank pâ¯= 0.049).CONCLUSION:
The treatment concept of 12â¯× 6â¯Gy is associated with 96% local progression-free survival for BC and 85% for pulmonary metastases after 3 years. There was no difference in response after SRT of primary lung carcinoma or pulmonary metastases.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Carcinoma Broncogênico
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Radiocirurgia
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Neoplasias Pulmonares
Tipo de estudo:
Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Female
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Humans
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article