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Toxicity of Proton Therapy versus Photon Therapy on Salvage Re-Irradiation for Non-Small Cell Lung Cancer

This study evaluated the toxicity associated with radiation techniques on curative re-irradiation (re-RT) in patients with thoracic recurrence of non-small cell lung cancer (NSCLC). From 2011 to 2019, we retrospectively reviewed the data of 63 patients with salvage re-RT for in-field or marginal rec...

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Autores principales: Yang, Kyungmi, Suh, Yang-Gun, Shin, Hyunju, Pyo, Hongryull, Moon, Sung Ho, Ahn, Yong Chan, Oh, Dongryul, Chung, Eunah, Jo, Kwanghyun, Noh, Jae Myoung
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8876714/
https://www.ncbi.nlm.nih.gov/pubmed/35207579
http://dx.doi.org/10.3390/life12020292
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author Yang, Kyungmi
Suh, Yang-Gun
Shin, Hyunju
Pyo, Hongryull
Moon, Sung Ho
Ahn, Yong Chan
Oh, Dongryul
Chung, Eunah
Jo, Kwanghyun
Noh, Jae Myoung
author_facet Yang, Kyungmi
Suh, Yang-Gun
Shin, Hyunju
Pyo, Hongryull
Moon, Sung Ho
Ahn, Yong Chan
Oh, Dongryul
Chung, Eunah
Jo, Kwanghyun
Noh, Jae Myoung
author_sort Yang, Kyungmi
collection PubMed
description This study evaluated the toxicity associated with radiation techniques on curative re-irradiation (re-RT) in patients with thoracic recurrence of non-small cell lung cancer (NSCLC). From 2011 to 2019, we retrospectively reviewed the data of 63 patients with salvage re-RT for in-field or marginal recurrence of NSCLC at two independent institutions. Re-RT techniques using X-ray beams and proton beam therapy (PBT) were also included. Re-RT had a 2-year overall survival (OS) and local progression-free survival of 48.0% and 52.0%, respectively. Fifteen patients experienced grade 3 or higher toxicity after re-RT. The complication rates were 18.2% (4/22) and 26.8% (11/41) in PBT patients and X-ray patients, respectively. Airway or esophageal fistulas occurred in seven patients (11.1%). Fistulas or severe airway obstruction occurred in patients with tumors adjacent to the proximal bronchial tree and esophagus, who underwent hypofractionated radiotherapy (RT) or concurrent chemotherapy, and with a higher dose exposure to the esophagus. In conclusion, salvage re-RT was feasible even in patients with local recurrence within the previous RT field. PBT showed similar survival outcomes and toxicity to those of other techniques. However, thoracic re-RT should be performed carefully considering tumor location and RT regimens such as the fraction size and concurrent chemotherapy.
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spelling pubmed-88767142022-02-26 Toxicity of Proton Therapy versus Photon Therapy on Salvage Re-Irradiation for Non-Small Cell Lung Cancer Yang, Kyungmi Suh, Yang-Gun Shin, Hyunju Pyo, Hongryull Moon, Sung Ho Ahn, Yong Chan Oh, Dongryul Chung, Eunah Jo, Kwanghyun Noh, Jae Myoung Life (Basel) Article This study evaluated the toxicity associated with radiation techniques on curative re-irradiation (re-RT) in patients with thoracic recurrence of non-small cell lung cancer (NSCLC). From 2011 to 2019, we retrospectively reviewed the data of 63 patients with salvage re-RT for in-field or marginal recurrence of NSCLC at two independent institutions. Re-RT techniques using X-ray beams and proton beam therapy (PBT) were also included. Re-RT had a 2-year overall survival (OS) and local progression-free survival of 48.0% and 52.0%, respectively. Fifteen patients experienced grade 3 or higher toxicity after re-RT. The complication rates were 18.2% (4/22) and 26.8% (11/41) in PBT patients and X-ray patients, respectively. Airway or esophageal fistulas occurred in seven patients (11.1%). Fistulas or severe airway obstruction occurred in patients with tumors adjacent to the proximal bronchial tree and esophagus, who underwent hypofractionated radiotherapy (RT) or concurrent chemotherapy, and with a higher dose exposure to the esophagus. In conclusion, salvage re-RT was feasible even in patients with local recurrence within the previous RT field. PBT showed similar survival outcomes and toxicity to those of other techniques. However, thoracic re-RT should be performed carefully considering tumor location and RT regimens such as the fraction size and concurrent chemotherapy. MDPI 2022-02-16 /pmc/articles/PMC8876714/ /pubmed/35207579 http://dx.doi.org/10.3390/life12020292 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Yang, Kyungmi
Suh, Yang-Gun
Shin, Hyunju
Pyo, Hongryull
Moon, Sung Ho
Ahn, Yong Chan
Oh, Dongryul
Chung, Eunah
Jo, Kwanghyun
Noh, Jae Myoung
Toxicity of Proton Therapy versus Photon Therapy on Salvage Re-Irradiation for Non-Small Cell Lung Cancer
title Toxicity of Proton Therapy versus Photon Therapy on Salvage Re-Irradiation for Non-Small Cell Lung Cancer
title_full Toxicity of Proton Therapy versus Photon Therapy on Salvage Re-Irradiation for Non-Small Cell Lung Cancer
title_fullStr Toxicity of Proton Therapy versus Photon Therapy on Salvage Re-Irradiation for Non-Small Cell Lung Cancer
title_full_unstemmed Toxicity of Proton Therapy versus Photon Therapy on Salvage Re-Irradiation for Non-Small Cell Lung Cancer
title_short Toxicity of Proton Therapy versus Photon Therapy on Salvage Re-Irradiation for Non-Small Cell Lung Cancer
title_sort toxicity of proton therapy versus photon therapy on salvage re-irradiation for non-small cell lung cancer
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8876714/
https://www.ncbi.nlm.nih.gov/pubmed/35207579
http://dx.doi.org/10.3390/life12020292
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