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Target volume definition for staple line recurrences of non-small cell lung cancer
BACKGROUND: Staple line (SL) recurrences of non-small cell lung cancer (NSCLC) are commonly treated with radiotherapy (RT), but the target volume definition — whole SL versus focused on recurrence — is unclear. The aim of the study was to determine the appropriate target volume for RT of SL recurren...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Via Medica
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8726443/ https://www.ncbi.nlm.nih.gov/pubmed/34992857 http://dx.doi.org/10.5603/RPOR.a2021.0090 |
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author | Nuzhat, Jan Mukhopadhyay, Nitai D. Weiss, Elisabeth |
author_facet | Nuzhat, Jan Mukhopadhyay, Nitai D. Weiss, Elisabeth |
author_sort | Nuzhat, Jan |
collection | PubMed |
description | BACKGROUND: Staple line (SL) recurrences of non-small cell lung cancer (NSCLC) are commonly treated with radiotherapy (RT), but the target volume definition — whole SL versus focused on recurrence — is unclear. The aim of the study was to determine the appropriate target volume for RT of SL recurrences. MATERIALS AND METHODS: Twenty-two consecutive patients (20 stage I, 2 stage II) treated with salvage RT for SL recurrences were retrospectively analyzed. Imaging features at the time of SL recurrence were evaluated to guide target volume definition. RESULTS: SURGERY: All patients had complete tumor resection (wedge resection in 10 (45%) and lobectomy in 12 (55%) patients). 14 (64%) patients had risk factors for recurrence, including surgical margins ≤ 2 cm, angiolymphatic and visceral pleural invasion. SALVAGE RT: After a median 26 months (9–67), all 22 patients developed SL recurrence which was metabolically active on PET in all and biopsy-confirmed in 18/22 (82%) patients. All patients underwent RT targeting the location of the SL recurrence only. 13/22 (59%) patients had additional PE T-negative nodular or linear SL changes that were not included in the irradiated volume. RECURRENCE AFTER RT: After a median 17 months (9–34) 10/22 (45%) patients recurred either regionally 6/10 (60%), in the lungs 4/10 (40%) or distally 3/10 (30%). No patient recurred at the SL. Two-year overall and disease-free survival rates after RT were 71% and 65%, respectively. CONCLUSION: RT to SL recurrences alone results in excellent local control. Additional treatment to reduce regional and distant recurrences should be considered. |
format | Online Article Text |
id | pubmed-8726443 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Via Medica |
record_format | MEDLINE/PubMed |
spelling | pubmed-87264432022-01-05 Target volume definition for staple line recurrences of non-small cell lung cancer Nuzhat, Jan Mukhopadhyay, Nitai D. Weiss, Elisabeth Rep Pract Oncol Radiother Research Paper BACKGROUND: Staple line (SL) recurrences of non-small cell lung cancer (NSCLC) are commonly treated with radiotherapy (RT), but the target volume definition — whole SL versus focused on recurrence — is unclear. The aim of the study was to determine the appropriate target volume for RT of SL recurrences. MATERIALS AND METHODS: Twenty-two consecutive patients (20 stage I, 2 stage II) treated with salvage RT for SL recurrences were retrospectively analyzed. Imaging features at the time of SL recurrence were evaluated to guide target volume definition. RESULTS: SURGERY: All patients had complete tumor resection (wedge resection in 10 (45%) and lobectomy in 12 (55%) patients). 14 (64%) patients had risk factors for recurrence, including surgical margins ≤ 2 cm, angiolymphatic and visceral pleural invasion. SALVAGE RT: After a median 26 months (9–67), all 22 patients developed SL recurrence which was metabolically active on PET in all and biopsy-confirmed in 18/22 (82%) patients. All patients underwent RT targeting the location of the SL recurrence only. 13/22 (59%) patients had additional PE T-negative nodular or linear SL changes that were not included in the irradiated volume. RECURRENCE AFTER RT: After a median 17 months (9–34) 10/22 (45%) patients recurred either regionally 6/10 (60%), in the lungs 4/10 (40%) or distally 3/10 (30%). No patient recurred at the SL. Two-year overall and disease-free survival rates after RT were 71% and 65%, respectively. CONCLUSION: RT to SL recurrences alone results in excellent local control. Additional treatment to reduce regional and distant recurrences should be considered. Via Medica 2021-12-30 /pmc/articles/PMC8726443/ /pubmed/34992857 http://dx.doi.org/10.5603/RPOR.a2021.0090 Text en © 2021 Greater Poland Cancer Centre https://creativecommons.org/licenses/by-nc-nd/4.0/This article is available in open access under Creative Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license, allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially |
spellingShingle | Research Paper Nuzhat, Jan Mukhopadhyay, Nitai D. Weiss, Elisabeth Target volume definition for staple line recurrences of non-small cell lung cancer |
title | Target volume definition for staple line recurrences of non-small cell lung cancer |
title_full | Target volume definition for staple line recurrences of non-small cell lung cancer |
title_fullStr | Target volume definition for staple line recurrences of non-small cell lung cancer |
title_full_unstemmed | Target volume definition for staple line recurrences of non-small cell lung cancer |
title_short | Target volume definition for staple line recurrences of non-small cell lung cancer |
title_sort | target volume definition for staple line recurrences of non-small cell lung cancer |
topic | Research Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8726443/ https://www.ncbi.nlm.nih.gov/pubmed/34992857 http://dx.doi.org/10.5603/RPOR.a2021.0090 |
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