Stereotactic body radiotherapy for chronic obstructive pulmonary disease patients undergoing or eligible for long-term domiciliary oxygen therapy.
A major cause of death in patients undergoing long-term domiciliary oxygen therapy (LTOT) is lung cancer progression. In our institution, we actively perform stereotactic body radiotherapy (SBRT) on patients with early-stage non-small-cell lung cancer undergoing LTOT. In this study, we retrospectively analyzed the treatment efficacy and safety of SBRT for patients with T1-3N0M0 non-small-cell lung cancer who had been prescribed LTOT for treatment of chronic obstructive pulmonary disease (COPD). A total of 24 patients were studied. Their median age was 74 years (range, 63-87 years). The median duration from the start of LTOT to SBRT was 23 months (range, 0-85 months). Four of the 24 patients underwent lobectomy due to lung cancer. The median follow-up duration was 29 months (range, 5-79 months). One patient had a local recurrence. The median survival time was 30 months. The 3-year overall survival was 49%. In 6 of the 24 patients (25%), COPD presented with interstitial pneumonia. The 3-year overall survival for patients with COPD without interstitial pneumonia was significantly better than that for patients with both COPD and interstitial pneumonia (67% and 0%, respectively; P < 0.0001). Grade 5 radiation pneumonitis occurred in one patient (4%) with COPD with interstitial pneumonia. SBRT was tolerated by patients with early-stage non-small-cell lung cancer undergoing LTOT. SBRT should be considered for patients undergoing LTOT. However, clinicians should consider the risk of severe radiation pneumonitis in patients with interstitial pneumonia.
Respiratory Disease Center, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan Radiation Oncology Center, Ofuna Chuo Hospital, Kamakura, Kanagawa, Japan Department of Infectious Diseases and Pulmonary Medicine, National Defense Medical College, Tokorozawa, Saitama, Japan.
Yu
Y
Hara
Radiation Oncology Center, Ofuna Chuo Hospital, Kamakura, Kanagawa, Japan takeda@1994.jukuin.keio.ac.jp.
Atsuya
A
Takeda
Radiation Oncology Center, Ofuna Chuo Hospital, Kamakura, Kanagawa, Japan.
Takahisa
T
Eriguchi
Radiation Oncology Center, Ofuna Chuo Hospital, Kamakura, Kanagawa, Japan.
Naoko
N
Sanuki
Radiation Oncology Center, Ofuna Chuo Hospital, Kamakura, Kanagawa, Japan.
Yousuke
Y
Aoki
Radiation Oncology Center, Ofuna Chuo Hospital, Kamakura, Kanagawa, Japan.
Shuichi
S
Nishimura
Department of Respiratory Medicine, Ofuna Chuo Hospital, Kamakura, Kanagawa, Japan.
Tatsuji
T
Enomoto
Respiratory Disease Center, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan Department of Infectious Diseases and Pulmonary Medicine, National Defense Medical College, Tokorozawa, Saitama, Japan.
Masaharu
M
Shinkai
Department of Infectious Diseases and Pulmonary Medicine, National Defense Medical College, Tokorozawa, Saitama, Japan.
Akihiko
A
Kawana
Respiratory Disease Center, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan Department of Respiratory Medicine, Ofuna Chuo Hospital, Kamakura, Kanagawa, Japan Department of Pulmonology, Yokohama City University Graduate School of Medicine, Kanazawa, Kanagawa, Japan.
Takeshi
T
Kaneko
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000627:therapeutic use*; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology / Q000532:radiotherapy*; D017564:Radiation Pneumonitis / Q000209:etiology; D016634:Radiosurgery / Q000379:methods*; D012129:Respiratory Function Tests; D013997:Time Factors
D010100:Oxygen
chronic obstructive pulmonary disease; interstitial pneumonia; long-term domiciliary oxygen therapy; lung cancer; radiation pneumonitis; stereotactic body radiotherapy