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10.3390/cancers12040885
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Article

Stereotactic Radiotherapy for Ultra-Central Lung Oligometastases in Non-Small-Cell Lung Cancer

by
Mauro Loi
1,*,
Davide Franceschini
1,
Luca Dominici
2,
Ciro Franzese
1,
Ilaria Chiola
1,
Tiziana Comito
1,
Marco Marzo
1,
Giacomo Reggiori
1,
Pietro Mancosu
1,
Stefano Tomatis
1,
Joost Nuyttens
3 and
Marta Scorsetti
1
1
Radiotherapy and Radiosurgery Department, Humanitas Cancer Center, 20089 Rozzano, Milan Area, Italy
2
Radiotherapy Department, University of Florence, 50100 Florence, Italy
3
Radiotherapy Department, Erasmus MC Cancer Center, 3015GD Rotterdam, The Netherlands
*
Author to whom correspondence should be addressed.
Cancers 2020, 12(4), 885; https://doi.org/10.3390/cancers12040885
Submission received: 14 March 2020 / Revised: 1 April 2020 / Accepted: 2 April 2020 / Published: 5 April 2020
(This article belongs to the Special Issue New Therapeutic Strategies for Lung Cancer)
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Abstract

Background: Stereotactic body radiotherapy (SBRT) in ultra-central (UC) lung tumors, defined in the presence of planning target volume (PTV) overlap or direct tumor abutment to the central bronchial tree or esophagus, may be correlated to a higher incidence of severe adverse events. Outcome and toxicity in oligometastatic (≤3 metastases) non-small-cell lung cancer (NSCLC) patients receiving SBRT for UC tumors were evaluated. Methods: Oligometastatic NSCLC patients treated with SBRT for UC were retrospectively reviewed. Local control (LC), distant metastasis-free survival (DMFS), progression-free survival (PFS) and overall survival (OS) were calculated. Incidence and grade of toxicity were evaluated. Statistical analysis was performed to assess the impact of clinical and treatment-related variables on outcome and toxicity occurrence. Results: Seventy-two patients were treated to a median biologically effective dose (BED) of 105 (75–132) Gy10. Two-year LC, DMFS, PFS, and OS were 83%, 46%, 43%, and 49%. BED>75 Gy10 was correlated to superior LC (p = 0.02), PFS (p = 0.036), and OS (p < 0.001). Grade ≥3 toxicity rate was 7%, including one fatal esophagitis. No variables were correlated to DMFS or to occurrence of overall and grade ≥3 toxicity. Conclusions: SBRT using dose-intensive schedules improves outcome in NSCLC patients. Overall toxicity is acceptable, although rare but potentially fatal toxicities may occur.
Keywords: non-small-cell lung cancer; ultra-central; stereotactic radiotherapy; oligometastases; biologically effective dose non-small-cell lung cancer; ultra-central; stereotactic radiotherapy; oligometastases; biologically effective dose
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MDPI and ACS Style

Loi, M.; Franceschini, D.; Dominici, L.; Franzese, C.; Chiola, I.; Comito, T.; Marzo, M.; Reggiori, G.; Mancosu, P.; Tomatis, S.; et al. Stereotactic Radiotherapy for Ultra-Central Lung Oligometastases in Non-Small-Cell Lung Cancer. Cancers 2020, 12, 885. https://doi.org/10.3390/cancers12040885

AMA Style

Loi M, Franceschini D, Dominici L, Franzese C, Chiola I, Comito T, Marzo M, Reggiori G, Mancosu P, Tomatis S, et al. Stereotactic Radiotherapy for Ultra-Central Lung Oligometastases in Non-Small-Cell Lung Cancer. Cancers. 2020; 12(4):885. https://doi.org/10.3390/cancers12040885

Chicago/Turabian Style

Loi, Mauro, Davide Franceschini, Luca Dominici, Ciro Franzese, Ilaria Chiola, Tiziana Comito, Marco Marzo, Giacomo Reggiori, Pietro Mancosu, Stefano Tomatis, and et al. 2020. "Stereotactic Radiotherapy for Ultra-Central Lung Oligometastases in Non-Small-Cell Lung Cancer" Cancers 12, no. 4: 885. https://doi.org/10.3390/cancers12040885

APA Style

Loi, M., Franceschini, D., Dominici, L., Franzese, C., Chiola, I., Comito, T., Marzo, M., Reggiori, G., Mancosu, P., Tomatis, S., Nuyttens, J., & Scorsetti, M. (2020). Stereotactic Radiotherapy for Ultra-Central Lung Oligometastases in Non-Small-Cell Lung Cancer. Cancers, 12(4), 885. https://doi.org/10.3390/cancers12040885

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