In-field stereotactic body radiotherapy (SBRT) reirradiation for pulmonary malignancies as a multicentre analysis of the German Society of Radiation Oncology (DEGRO)

• Published in: Scientific reports Vol. 11; no. 1; p. 4590
• Main Authors: John, Caroline, Dal Bello, Riccardo, Andratschke, Nicolaus, Guckenberger, Matthias, Boda-Heggemann, Judit, Gkika, Eleni, Mantel, Frederick, Specht, Hanno M, Stromberger, Carmen, Zehentmayr, Franz, Blanck, Oliver, Balermpas, Panagiotis
• Format: Journal Article
• Language: English
• Published: England Nature Publishing Group 25.02.2021; Nature Publishing Group UK; Nature Portfolio
• Subjects: Adult; Aged; Aged, 80 and over; Feasibility studies; Female; Germany; Humans; Lung cancer; Lung Neoplasms - diagnostic imaging; Lung Neoplasms - radiotherapy; Male; Metastases; Middle Aged; Non-small cell lung carcinoma; Pneumonitis; Radiation therapy; Radiosurgery - methods; Retrospective Studies; Salvage Therapy; Thorax; Toxicity; Germany
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-021-83210-3

Data of thoracic in-field reirradiation with two courses of stereotactic body radiotherapy (SBRT) is scarce. Aim of this study is to investigate feasibility and safety of this approach. Patients with a second course of thoracic SBRT and planning target volume (PTV) overlap were analyzed in this retrospective, multicenter study. All plans and clinical data were centrally collected. 27 patients from 8 centers have been amenable for evaluation: 12 with non-small-cell lung cancer, 16 with metastases, treated from 2009 (oldest first course) to 2020 (latest second course). A median dose of 38.5 Gy to the 65%-isodose over a median of 5 fractions was prescribed in the first course and 40 Gy in 5 fractions for the second SBRT-course. Median PTV of the second SBRT was 29.5 cm , median PTV overlap 22 cm . With a median interval of 20.2 months between the two SBRT-courses, 1-year OS, and -LCR were 78.3% and 70.3% respectively. 3 patients developed grade 1 and one grade 2 pneumonitis. No grade > 2 toxicity was observed. Peripheral location and dose were the only factors correlating with tumor control. A second SBRT-course with PTV overlap appears safe and achieves reasonable local control.