ArticleRadiation oncology (London, England)2017
Five-fraction SBRT for ultra-central NSCLC in-field recurrences following high-dose conventional radiation.
Article in Radiation oncology (London, England), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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12 citing papers in PubMed, 32 citations in OpenAlex.
- Outcome and safety of SBRT in centrally and ultra-centrally located lung tumours: A PRISMA-based systematic review and Meta-Analysis.Clinical and translational radiation oncology · 2026Article
- Standardising image registration and dose mapping for thoracic reirradiation: A national multi-centre benchmarking study.Physics and imaging in radiation oncology · 2026Article
- Outcomes and Toxicity following 3 or More Definitive Courses of Thoracic Radiation Therapy for Non-Small Cell Lung Cancer.Clinical lung cancer · 2025Article
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- Reirradiation of Utracentrally Located Thoracic Tumors Using a 10-Fraction Hypofractionated Stereotactic Body Radiation Therapy Course: A Detailed Dosimetric Analysis.Advances in radiation oncology · 2024Article
- Salvage Reirradiation with Proton Beam Therapy for Locoregionally Recurrent Non-Small Cell Lung Cancer.Cancers · 2024Article
- Stereotactic body proton therapy for non-small cell lung cancer: Clinical indications and recommendations.Journal of radiosurgery and SBRT · 2023Article
- Risk-adapted stereotactic body radiation therapy for central and ultra-central early-stage inoperable non-small cell lung cancer.Cancer science · 2019Article
- Stereotactic body radiotherapy as salvage treatment for recurrence of non-small cell lung cancer after prior surgery or radiotherapy.Translational lung cancer research · 2019Review
- Repeat Thoracic Stereotactic Body Radiation Therapy (SBRT) for Nonsmall Cell Lung Cancer: Long-Term Outcomes, Toxicity, and Dosimetric Considerations.Advances in radiation oncologyArticle
- Reirradiation: Standards, challenges, and patient-focused strategies across tumor types.CA: a cancer journal for cliniciansReview
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
PURPOSE/
objectiveLocal treatment options for patients with in-field non-small cell lung cancer (NSCLC) recurrence following conventionally fractionated external beam radiation therapy (CF-EBRT) are limited. Stereotactic body radiation therapy (SBRT) is a promising modality to achieve reasonable local control, although toxicity remains a concern. MATERIALS/
methodsPatients previously treated with high-dose CF-EBRT (≥59.4 Gy, ≤3 Gy/fraction) for non-metastatic NSCLC who underwent salvage SBRT for localized ultra-central in-field recurrence were included in this analysis. Ultra-central recurrences were defined as those abutting the trachea, mainstem bronchus, or esophagus and included both parenchymal and nodal recurrences. The Kaplan-Meier method was used to estimate local control and overall survival. Durable local control was defined as ≥12 months. Toxicity was scored per the CTC-AE v4.0.
resultsTwenty patients were treated with five-fraction robotic SBRT for ultra-central in-field recurrence following CF-EBRT. Fifty percent of recurrences were adenocarcinoma, while 35% of tumors were classified as squamous cell carcinoma. The median interval between the end of CF-EBRT and SBRT was 23.3 months (range: 2.6 - 93.6 months). The median CF-EBRT dose was 63 Gy (range: 59.4 - 75 Gy), the median SBRT dose was 35 Gy (range: 25 - 45 Gy), and the median total equivalent dose in 2 Gy fractions (EQD2) was 116 Gy (range: 91.3 - 136.7 Gy). At a median follow-up of 12 months for all patients and 37.5 months in surviving patients, the majority of patients (90%) have died. High-dose SBRT was associated with improved local control (p < .01), and the one-year overall survival and local control were 77.8% and 66.7% respectively in this sub-group. No late esophageal toxicity was noted, although a patient who received an SBRT dose of 45 Gy (total EQD2: 129.7 Gy) experienced grade 5 hemoptysis 35 months following treatment.
conclusionsAlthough the overall prognosis for patients with in-field ultra-central NSCLC recurrences following CF-EBRT remains grim, five-fraction SBRT was well tolerated with an acceptable toxicity profile. Dose escalation above 35 Gy may offer improved local control, however caution is warranted when treating high-risk recurrences with aggressive regimens.
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