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Hypofractionated image-guided radiation therapy for patients with limited volume metastatic non-small cell lung cancer.

Publication ,  Journal Article
Hasselle, MD; Haraf, DJ; Rusthoven, KE; Golden, DW; Salgia, R; Villaflor, VM; Shah, N; Hoffman, PC; Chmura, SJ; Connell, PP; Vokes, EE ...
Published in: J Thorac Oncol
February 2012

INTRODUCTION: Outcomes data treating patients with oligometastatic (≤ 5 metastases) non-small cell lung carcinoma (NSCLC) with hypofractionated image-guided radiotherapy (HIGRT) are limited. METHODS: Consecutive oligometastatic NSCLC patients were reviewed from a prospective database. Patients were included if all active diseases were treated with HIGRT. Lesions that had received prior radiation or had radiographic/metabolic resolution after chemotherapy were not treated with HIGRT. Local control of all treated lesions, distant control, progression-free survival (PFS), overall survival (OS), and control of individual lesions (LeC) were calculated. RESULTS: Twenty-five patients with median of 2 treated oligometastatic lesions were included. Median follow-up was 14 months. Median age was 66 years. Nineteen patients received systemic therapy before HIGRT and 11 had progressive disease after their most recent systemic therapy before HIGRT. Median OS and PFS were 22.7 and 7.6 months. The 18 months local control, distant control, OS, and PFS were 66.1%, 31.7%, 52.9%, and 28.0%. Greater than two sites treated with HIGRT, nonadenocarcinoma histology, prior systemic therapy, and progression after systemic therapy were associated with worse PFS. Sixty-two individual lesions of median size 2.7 cm were treated. For extracranial lesions, median total and fraction dose were 50 and 5 Gy. Median standard equivalent dose in 2 Gy fractions for extracranial lesions was 64.6 Gy yielding 18 months LeC of 70.7%. Standard equivalent dose ≥64.6 Gy increased LeC (p = 0.04). Two patients experienced grade 3 toxicity. CONCLUSIONS: HIGRT for oligometastatic NSCLC provides durable LeC and may provide long-term PFS in some patients. Future HIGRT studies should optimize patient selection and integration with systemic therapy.

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Published In

J Thorac Oncol

DOI

EISSN

1556-1380

Publication Date

February 2012

Volume

7

Issue

2

Start / End Page

376 / 381

Location

United States

Related Subject Headings

  • Survival Rate
  • Retrospective Studies
  • Radiotherapy, Image-Guided
  • Prospective Studies
  • Prognosis
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Neoplasm Recurrence, Local
  • Middle Aged
  • Male
 

Citation

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Hasselle, M. D., Haraf, D. J., Rusthoven, K. E., Golden, D. W., Salgia, R., Villaflor, V. M., … Salama, J. K. (2012). Hypofractionated image-guided radiation therapy for patients with limited volume metastatic non-small cell lung cancer. J Thorac Oncol, 7(2), 376–381. https://doi.org/10.1097/JTO.0b013e31824166a5
Hasselle, Michael D., Daniel J. Haraf, Kyle E. Rusthoven, Daniel W. Golden, Ravi Salgia, Victoria M. Villaflor, Niket Shah, et al. “Hypofractionated image-guided radiation therapy for patients with limited volume metastatic non-small cell lung cancer.J Thorac Oncol 7, no. 2 (February 2012): 376–81. https://doi.org/10.1097/JTO.0b013e31824166a5.
Hasselle MD, Haraf DJ, Rusthoven KE, Golden DW, Salgia R, Villaflor VM, et al. Hypofractionated image-guided radiation therapy for patients with limited volume metastatic non-small cell lung cancer. J Thorac Oncol. 2012 Feb;7(2):376–81.
Hasselle, Michael D., et al. “Hypofractionated image-guided radiation therapy for patients with limited volume metastatic non-small cell lung cancer.J Thorac Oncol, vol. 7, no. 2, Feb. 2012, pp. 376–81. Pubmed, doi:10.1097/JTO.0b013e31824166a5.
Hasselle MD, Haraf DJ, Rusthoven KE, Golden DW, Salgia R, Villaflor VM, Shah N, Hoffman PC, Chmura SJ, Connell PP, Vokes EE, Weichselbaum RR, Salama JK. Hypofractionated image-guided radiation therapy for patients with limited volume metastatic non-small cell lung cancer. J Thorac Oncol. 2012 Feb;7(2):376–381.
Journal cover image

Published In

J Thorac Oncol

DOI

EISSN

1556-1380

Publication Date

February 2012

Volume

7

Issue

2

Start / End Page

376 / 381

Location

United States

Related Subject Headings

  • Survival Rate
  • Retrospective Studies
  • Radiotherapy, Image-Guided
  • Prospective Studies
  • Prognosis
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Neoplasm Recurrence, Local
  • Middle Aged
  • Male