title: Re-irradiation plus regional hyperthermia for recurrent non-small cell lung cancer: a potential modality for inducing long-term survival in selected patients.
abstract: OBJECTIVE
  The purpose of this study was to assess the toxicity and efficacy of re-irradiation plus regional hyperthermia for recurrent NSCLC and to identify the predictors of long-term survival.
  
  
  METHODS
  A total of 33 patients with recurrent NSCLC treated with re-irradiation plus regional hyperthermia were retrospectively analyzed. The median total dose of initial radiotherapy and re-irradiation were 70 Gy and 50 Gy, respectively. A median of 5 hyperthermia treatments using an 8-MHz radiofrequency-capacitive device were applied during re-irradiation in all patients.
  
  
  RESULTS
  Toxicity of Grade 3 was seen in 3 (9%) patients, and no Grade 4 or 5 toxicity was observed. The median overall survival, local control, and disease progression-free survival times after re-irradiation were 18.1, 12.1, and 6.7 months, respectively. Eight patients achieved a long-term survival (more than 3 years after re-irradiation), and 4 of them underwent a third round of irradiation for re-recurrent tumors. Univariate analyses showed that a smaller tumor size (<4 cm) and the absence of distant metastases were significant predictors for a better overall survival. The absence of distant metastases was also found to be a significant predictor for better disease progression-free survival in the univariate analyses. In the subset analyses of 23 patients treated with hyperthermia using electrodes of 30 cm in diameter, the use of a higher radiofrequency-output power tended to be associated with a better prognosis in terms of the local control rate.
  
  
  CONCLUSIONS
  Re-irradiation plus regional hyperthermia for recurrent NSCLC appears feasible, with acceptable toxicity, and may be a promising treatment that can result in the long-term survival of patients without distant metastasis and larger recurrent tumors.
authors.affiliation: Department of Radiology, University of Occupational and Environmental Health, Kitakyushu, Japan. ogurieye@med.uoeh-u.ac.jp
authors.forename: Takayuki
authors.initials: T
authors.lastname: Ohguri
authors.forename: Hajime
authors.initials: H
authors.lastname: Imada
authors.forename: Katsuya
authors.initials: K
authors.lastname: Yahara
authors.forename: Seung Dae
authors.initials: SD
authors.lastname: Moon
authors.forename: Shinsaku
authors.initials: S
authors.lastname: Yamaguchi
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Yatera
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Mukae
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hanagiri
authors.forename: Fumihiro
authors.initials: F
authors.lastname: Tanaka
authors.forename: Yukunori
authors.initials: Y
authors.lastname: Korogi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D011879:Radiotherapy Dosage; D011881:Radiotherapy, Computer-Assisted; D019233:Retreatment; D012189:Retrospective Studies; D016896:Treatment Outcome; D047368:Tumor Burden