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  • 2025년 01월호
    [Asia Pac J Clin Oncol .] Treatment patterns and results of salvage treatment for regional recurrences after stereotactic ablative radiotherapy for primary non-small cell lung cancer

    서울의대 / 이충원, 김병혁*, 우홍균*, 김학재*

  • 출처
    Asia Pac J Clin Oncol .
  • 등재일
    2024 Oct
  • 저널이슈번호
    20(5):652-660. doi: 10.1111/ajco.13992. Epub 2023 Jul 5.
  • 내용

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    Abstract
    Purpose: Stereotactic ablative radiotherapy (SABR) for early-stage lung cancer has shown promising results; however, regional recurrence (RR) development is not uncommon, and salvage treatment strategies have not been established. We aimed to investigate treatment patterns, prognostic factors, and survival outcomes.

    Materials and methods: A retrospective analysis of 391 patients who underwent SABR for primary lung cancer from 2012 to 2019 was performed. Among these patients, 90 patients showed recurrence, including local recurrence (n = 9), RR (n = 33), distant metastasis (DM) (n = 57), and RR with simultaneous DM (n = 8). The median follow-up duration was 17.3 months.

    Results: The median age was 75 years, and most patients underwent primary SABR due to poor lung function (69.7%). Various salvage treatments were performed in cases of RR, including chemotherapy (n = 15), radiotherapy (n = 7), concurrent chemoradiotherapy (n = 2), and best supportive care (n = 9). The median overall survival (OS) and post-recurrence OS (PR-OS) were 22.9 and 11.2 months, respectively. In multivariate analysis, age ≤75 years (HR = 0.36, p = 0.040), isolated recurrence (HR = 0.34, p = 0.037), and radiotherapy without chemotherapy (HR = 0.25, p = 0.024) were significant prognostic factors for PR-OS.

    Conclusions: Despite various salvage treatments, PR-OS was less than 1 year after RR in our frail patients group who underwent primary SABR. The toxicities of salvage chemotherapy could be quite severe; thus, careful patient selection is required. Further research is needed to validate our findings.

     

     

    Affiliations

    Choong-Won Lee 1, Byoung Hyuck Kim 2 3, Hong-Gyun Wu 1 3, Hak Jae Kim 1 3
    1Department of Radiation Oncology, Seoul National University Hospital, Seoul, Republic of Korea.
    2Department of Radiation Oncology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
    3Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Republic of Korea.

  • 키워드
    SABR; non‐small cell lung cancer; regional recurrence; salvage treatment.
  • 편집위원

    SABR 후 regional recurrence (further than 2 cm from the PTV margin in the same lobe or involved lymph node enlargement in the hilum, mediastinum, or supraclavicular fossa)가 발생한 환자들에서 추가 치료와 생존율을 분석한 흥미로운 연구입니다.

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