Stereotactic body radiotherapy for lung cancer patients with idiopathic interstitial pneumonias. Issue 2 (November 2017)

• Record Type: Journal Article
• Authors: Tsurugai, Yuichiro; Takeda, Atsuya; Sanuki, Naoko; Enomoto, Tatsuji; Kaneko, Takeshi; Hara, Yu; Mizuno, Tomikazu; Saeki, Noriyuki; Aoki, Yousuke; Oku, Yohei; Akiba, Takeshi; Kunieda, Etsuo
• Is Part Of: Radiotherapy and oncology. Volume 125:Issue 2(2017:Nov.)
• Page Start: 310
• Page End: 316
• Publication Date: 2017-11
• Subjects: Radiation pneumonitis -- SBRT -- SABR -- Idiopathic interstitial pneumonias -- Pulmonary toxicity; ILD interstitial lung disease -- SBRT stereotactic body radiotherapy -- IIPs idiopathic interstitial pneumonias -- 18F-FDG PET/CT [18F]-fluorodeoxyglucose positron emission tomography/computed tomography -- UIP usual interstitial pneumonia -- CPFE combined pulmonary fibrosis with emphysema -- ITV internal target volume -- PTV planning target volume -- KL-6 Krebs von den Lungen-6 -- SP-D surfactant protein D -- CRP C reactive protein -- OS overall survival -- ATS/ERS/JRS/ALAT American thoracic society/European respiratory society/Japanese respiratory society/Latin American thoracic association -- AE acute exacerbation -- RP radiation pneumonitis -- NSCLC non-small cell lung cancer -- CRP C reactive protein -- SUV standardized uptake value -- CI confidence interval -- FEV1.0 forced expiratory volume in 1 s -- GOLD global initiative for chronic obstructive lung disease -- V20 lung volume irradiated with ≥20 Gy -- MLD mean lung dose -- HRCT high resolution computed tomography -- NSIP nonspecific interstitial pneumonia -- RTKs receptor tyrosine kinases -- ILD interstitial lung disease; Oncology -- Periodicals; Radiotherapy -- Periodicals; Tumors -- Periodicals; Medical Oncology -- Periodicals; Neoplasms -- radiotherapy -- Periodicals; Radiotherapy -- Periodicals; Radiothérapie -- Périodiques; Cancérologie -- Périodiques; Tumeurs -- Périodiques; Electronic journals; 616.9940642
• DOI: 10.1016/j.radonc.2017.08.026
• Languages: English
• ISSNs: 0167-8140

Abstract

Abstract: Purpose: To compare toxicity and survival after stereotactic body radiotherapy (SBRT) between lung cancer patients with or without idiopathic interstitial pneumonias (IIPs), and to investigate the potential value of SBRT for the patients. Methods: Among lung cancer patients receiving SBRT between 2005 and 2016, we evaluated those treated with a total dose of 40–60 Gy in five fractions with curative intent who either were staged as cT1-4N0M0 or experienced postoperative isolated local recurrence. We analyzed the incidence of radiation pneumonitis (RP) in all patients and local recurrence and overall survival (OS) in T1a-2a patients. Results: A total of 508 patients were eligible, including 42 with IIPs. The median follow-up was 32.3 (6.0–120.9) months. Significantly more patients with IIPs had grade ≥3 RP than did those without IIPs (12% vs. 3%, p = 0.009). The 2-year local recurrence rate was low in both groups (3.4% vs. 5.6%, p = 0.38). The 2-year OS rate was significantly lower in the patients with IIPs (42.2% vs. 80.9%, p < 0.001), although death from lung cancer was comparable ( p = 0.74). Conclusion: SBRT achieved excellent local control with acceptable pulmonary toxicity in lung cancer patients with IIPs. SBRT can be a reasonable option for early lung cancer patients with IIPs.