J Lung Cancer.  2011 Jun;10(1):37-43. 10.6058/jlc.2011.10.1.37.

Radiotherapy for Locoregional Recurrent Non-Small Cell Lung Cancer

• Kim MY
• Kim JS
• Lee JS

• KMID: 2199893
• DOI: http://doi.org/10.6058/jlc.2011.10.1.37

Abstract

PURPOSE
To retrospectively evaluate the outcomes and complications of curative radiotherapy for locoregionally recurrent non-small cell lung cancer (NSCLC).
MATERIALS AND METHODS
From 2004 to 2008, 21 patients received curative radiotherapy for locoregionally recurrent NSCLC without systemic metastasis after surgery. At the time of recurrence, the median age was 70 years (range 49~81 years), and 19 patients were male. Most patients (n=17) were ECOG 0 or 1 performance status. The median disease-free interval was 15 months. Distribution of recurrence sites were mediastinal lymph nodes (n=10), ipsilateral hilar lymph nodes (n=4), ipsilateral lung parenchyma (n=4), bronchial stump (n=2) and ipsilateral supraclavicular lymph nodes (n=1). Radiotherapy was administered (median 66 Gy, range 59.4~70 Gy) by a three-dimensional conformal technique. Thirteen patients received chemotherapy concurrently during radiotherapy. Pulmonary function test (PFT) was also used to detect lung function change before and after radiation.
RESULTS
The median survival and 1- and 2-year survival rates were 17 months, 68% and 34%, respectively. Concurrent chemotherapy did not affect post-recurrence overall survival (p=0.183). Seven patients (33% of all patients) had re-progression within the radiation field at a median time of 4 months after completion of radiation. Diffusing lung capacity for carbon monoxide of lung after radiotherapy decreased significantly compared with pre-radiotherapy status (p=0.033). Radiation pneumonitis of any grade was seen in 11 patients. Three patients died of pulmonary complications: one of bacterial pneumonia, one of exacerbation of underlying interstitial pulmonary fibrosis and one of radiation pneumonitis.
CONCLUSION
This retrospective study showed that curative radiotherapy for locoregionally recurrent NSCLC resulted in a median survival of 17 months and a 2-year survival rate of 34%, which is comparable to other studies. Patients suitable for curative radiotherapy for recurrent NSCLC could be treated aggressively, such as using high dose radiation with or without chemotherapy. However, pre-radiotherapy lung function should be carefully evaluated to avoid serious post-treatment lung damage considering poor lung function of post-resection patients.

Keyword

Non-small cell lung carcinoma; Local recurrence; Radiotherapy

MeSH Terms

Carbon Monoxide
Carcinoma, Non-Small-Cell Lung
Humans
Lung
Lung Volume Measurements
Lymph Nodes
Male
Neoplasm Metastasis
Pneumonia, Bacterial
Pulmonary Fibrosis
Radiation Pneumonitis
Recurrence
Respiratory Function Tests
Retrospective Studies
Survival Rate
Carbon Monoxide

Figure

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  Fig. 1. Overall survival rate.

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  Fig. 2. Overall survival rate according to the use of chemotherapy. CCRT: concurrent chemoradiotherapy.

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