Risk of Pneumonitis After Stereotactic Body Radiation Therapy in Patients With Previous Anatomic Lung Resection

Jason T. Hayes, Elizabeth David, Lihong Qi, Allen M. Chen, Megan E Daly

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background Stereotactic body radiation therapy (SBRT) has emerged as a standard treatment of early-stage, medically inoperable lung cancer. Limited data have evaluated the radiation pneumonitis (RP) risk with SBRT after previous anatomic lung resection (ALR). We assessed the incidence of RP and all pulmonary toxicity (PT) in patients who underwent lung SBRT after ALR and compared them with those of patients without previous ALR. Materials and Methods We reviewed the medical records of 84 consecutively treated patients with stage T1-T2b non-small-cell lung cancer (NSCLC) treated with 88 courses of SBRT for 94 lung tumors from January 2007 to December 2014, including 17 patients with previous ALR. The rates of RP and all PT were compared between the patients with and without previous ALR. Results At a median follow-up duration of 18.3 months (range, 1.8-85.6 months), the crude grade 2+ RP rate was 5.9% and 2.8% for patients with and without previous ALR, respectively (P =.51). The corresponding 2-year estimates of freedom from RP were 89% and 97% (P =.51). The crude rate of all grade 2+ PT was 11.8% and 2.8% for those with and without previous ALR (P =.11), with 2-year estimates of freedom from PT of 97% and 84% (P =.11), respectively. The 2 cohorts were well matched by the mean lung dose, percentage of lung volume receiving 20 Gy (P =.86), and prescribed dose (P =.75). The 2-year estimates of local control, cause-specific survival, and overall survival were similar between the 2 cohorts. Conclusion The observed rates of PT were low among all patients, with a trend toward increased grade 2 and 3 lung toxicity among patients with previous ALR. Previous ALR did not increase the risk of grade 4 and 5 RP, and SBRT appears safe and effective in this population.

Original languageEnglish (US)
Article number350
Pages (from-to)379-384
Number of pages6
JournalClinical Lung Cancer
Volume16
Issue number5
DOIs
StatePublished - Sep 1 2015

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Pneumonia
Radiotherapy
Lung
Radiation Pneumonitis
Survival
Non-Small Cell Lung Carcinoma
Medical Records
Lung Neoplasms

Keywords

  • Lung resection
  • Non-small-cell lung cancer
  • Radiation pneumonitis
  • SBRT
  • Toxicity

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Pulmonary and Respiratory Medicine

Cite this

Risk of Pneumonitis After Stereotactic Body Radiation Therapy in Patients With Previous Anatomic Lung Resection. / Hayes, Jason T.; David, Elizabeth; Qi, Lihong; Chen, Allen M.; Daly, Megan E.

In: Clinical Lung Cancer, Vol. 16, No. 5, 350, 01.09.2015, p. 379-384.

Research output: Contribution to journalArticle

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title = "Risk of Pneumonitis After Stereotactic Body Radiation Therapy in Patients With Previous Anatomic Lung Resection",
abstract = "Background Stereotactic body radiation therapy (SBRT) has emerged as a standard treatment of early-stage, medically inoperable lung cancer. Limited data have evaluated the radiation pneumonitis (RP) risk with SBRT after previous anatomic lung resection (ALR). We assessed the incidence of RP and all pulmonary toxicity (PT) in patients who underwent lung SBRT after ALR and compared them with those of patients without previous ALR. Materials and Methods We reviewed the medical records of 84 consecutively treated patients with stage T1-T2b non-small-cell lung cancer (NSCLC) treated with 88 courses of SBRT for 94 lung tumors from January 2007 to December 2014, including 17 patients with previous ALR. The rates of RP and all PT were compared between the patients with and without previous ALR. Results At a median follow-up duration of 18.3 months (range, 1.8-85.6 months), the crude grade 2+ RP rate was 5.9{\%} and 2.8{\%} for patients with and without previous ALR, respectively (P =.51). The corresponding 2-year estimates of freedom from RP were 89{\%} and 97{\%} (P =.51). The crude rate of all grade 2+ PT was 11.8{\%} and 2.8{\%} for those with and without previous ALR (P =.11), with 2-year estimates of freedom from PT of 97{\%} and 84{\%} (P =.11), respectively. The 2 cohorts were well matched by the mean lung dose, percentage of lung volume receiving 20 Gy (P =.86), and prescribed dose (P =.75). The 2-year estimates of local control, cause-specific survival, and overall survival were similar between the 2 cohorts. Conclusion The observed rates of PT were low among all patients, with a trend toward increased grade 2 and 3 lung toxicity among patients with previous ALR. Previous ALR did not increase the risk of grade 4 and 5 RP, and SBRT appears safe and effective in this population.",
keywords = "Lung resection, Non-small-cell lung cancer, Radiation pneumonitis, SBRT, Toxicity",
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T1 - Risk of Pneumonitis After Stereotactic Body Radiation Therapy in Patients With Previous Anatomic Lung Resection

AU - Hayes, Jason T.

AU - David, Elizabeth

AU - Qi, Lihong

AU - Chen, Allen M.

AU - Daly, Megan E

PY - 2015/9/1

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N2 - Background Stereotactic body radiation therapy (SBRT) has emerged as a standard treatment of early-stage, medically inoperable lung cancer. Limited data have evaluated the radiation pneumonitis (RP) risk with SBRT after previous anatomic lung resection (ALR). We assessed the incidence of RP and all pulmonary toxicity (PT) in patients who underwent lung SBRT after ALR and compared them with those of patients without previous ALR. Materials and Methods We reviewed the medical records of 84 consecutively treated patients with stage T1-T2b non-small-cell lung cancer (NSCLC) treated with 88 courses of SBRT for 94 lung tumors from January 2007 to December 2014, including 17 patients with previous ALR. The rates of RP and all PT were compared between the patients with and without previous ALR. Results At a median follow-up duration of 18.3 months (range, 1.8-85.6 months), the crude grade 2+ RP rate was 5.9% and 2.8% for patients with and without previous ALR, respectively (P =.51). The corresponding 2-year estimates of freedom from RP were 89% and 97% (P =.51). The crude rate of all grade 2+ PT was 11.8% and 2.8% for those with and without previous ALR (P =.11), with 2-year estimates of freedom from PT of 97% and 84% (P =.11), respectively. The 2 cohorts were well matched by the mean lung dose, percentage of lung volume receiving 20 Gy (P =.86), and prescribed dose (P =.75). The 2-year estimates of local control, cause-specific survival, and overall survival were similar between the 2 cohorts. Conclusion The observed rates of PT were low among all patients, with a trend toward increased grade 2 and 3 lung toxicity among patients with previous ALR. Previous ALR did not increase the risk of grade 4 and 5 RP, and SBRT appears safe and effective in this population.

AB - Background Stereotactic body radiation therapy (SBRT) has emerged as a standard treatment of early-stage, medically inoperable lung cancer. Limited data have evaluated the radiation pneumonitis (RP) risk with SBRT after previous anatomic lung resection (ALR). We assessed the incidence of RP and all pulmonary toxicity (PT) in patients who underwent lung SBRT after ALR and compared them with those of patients without previous ALR. Materials and Methods We reviewed the medical records of 84 consecutively treated patients with stage T1-T2b non-small-cell lung cancer (NSCLC) treated with 88 courses of SBRT for 94 lung tumors from January 2007 to December 2014, including 17 patients with previous ALR. The rates of RP and all PT were compared between the patients with and without previous ALR. Results At a median follow-up duration of 18.3 months (range, 1.8-85.6 months), the crude grade 2+ RP rate was 5.9% and 2.8% for patients with and without previous ALR, respectively (P =.51). The corresponding 2-year estimates of freedom from RP were 89% and 97% (P =.51). The crude rate of all grade 2+ PT was 11.8% and 2.8% for those with and without previous ALR (P =.11), with 2-year estimates of freedom from PT of 97% and 84% (P =.11), respectively. The 2 cohorts were well matched by the mean lung dose, percentage of lung volume receiving 20 Gy (P =.86), and prescribed dose (P =.75). The 2-year estimates of local control, cause-specific survival, and overall survival were similar between the 2 cohorts. Conclusion The observed rates of PT were low among all patients, with a trend toward increased grade 2 and 3 lung toxicity among patients with previous ALR. Previous ALR did not increase the risk of grade 4 and 5 RP, and SBRT appears safe and effective in this population.

KW - Lung resection

KW - Non-small-cell lung cancer

KW - Radiation pneumonitis

KW - SBRT

KW - Toxicity

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