Available evidence on re-irradiation with stereotactic ablative radiotherapy following high-dose previous thoracic radiotherapy for lung malignancies.
Patients affected with intra-thoracic recurrences of primary or secondary lung malignancies after a first course of definitive radiotherapy have limited therapeutic options, and they are often treated with a palliative intent. Re-irradiation with stereotactic ablative radiotherapy (SABR) represents an appealing approach, due to the optimized dose distribution that allows for high-dose delivery with better sparing of organs at risk. This strategy has the goal of long-term control and even cure. Aim of this review is to report and discuss published data on re-irradiation with SABR in terms of efficacy and toxicity. Results indicate that thoracic re-irradiation may offer satisfactory disease control, however the data on outcome and toxicity are derived from low quality retrospective studies, and results should be cautiously interpreted. As SABR may be associated with serious toxicity, attention should be paid for an accurate patients' selection.
Radiation Oncology Department, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland.
Berardino
B
De Bari
Department of Oncology, Radiation Oncology, University of Turin, Turin, Italy. Electronic address: andreariccardo.filippi@unito.it.
Andrea Riccardo
AR
Filippi
Radiation Oncology Department, University of Palermo, Palermo, Italy.
Rosario
R
Mazzola
Radiation Oncology Department, University of Florence, Italy.
Pierluigi
P
Bonomo
Radiation Oncology Department, Centro di Riferimento Oncologico, Aviano, Italy.
Marco
M
Trovò
Radiation Oncology Department, University of Florence, Italy.
Lorenzo
L
Livi
Radiation Oncology Department, Sacro Cuore-Don Calabria Hospital, Negrar-Verona, Italy.
Filippo
F
Alongi
D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*; D018579:Patient Selection; D016634:Radiosurgery / Q000009:adverse effects; D011879:Radiotherapy Dosage; D013909:Thorax / Q000528:radiation effects*
Lung cancer; Re-irradiation; Stereotactic ablative radiotherapy; Stereotactic body radiotherapy; Thoracic relapse