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Regional lymph node recurrence after stereotactic body radiation therapy for lung cancer: Patterns of recurrence, treatment approaches, and clinical outcomes (KROG 21-09)

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Author(s)
Tae Hoon LeeHyunju ShinYong Chan AhnMin Kyu KangChanghoon SongWoo Chul KimSung Ho MoonJin Hee KimJaeho ChoHae Jin ParkHeui Kwan LeeByoung Hyuck KimHak Jae Kim
Keimyung Author(s)
Kim, Jin Hee
Department
Dept. of Radiation Oncology (방사선종양학)
Journal Title
Radiother Oncol
Issued Date
2023
Volume
183
Keyword
Lung cancerLymphatic metastasisSalvage therapyStereotactic body radiotherapy
Abstract
Purpose:
To present the multi-institutional data on patterns of recurrence, treatment approaches, and clinical outcomes for regional lymph node (LN) recurrence after stereotactic body radiation therapy (SBRT) for primary lung cancer.

Materials and methods:
The medical records of 114 patients who experienced regional LN recurrence as the first recurrence after lung SBRT were retrospectively reviewed. Patterns of recurrence were classified as local recurrence, regional recurrence, and distant metastasis. Clinical outcomes including progression-free survival (PFS) and overall survival (OS) were analyzed.

Results:
Half of the patients had regional LN recurrence only. The most common simultaneous recurrence was distant metastasis (38.6 %). Common sites of regional recurrence were ipsilateral hilar (47.2 %), ipsilateral upper mediastinal (40.6 %), and subcarinal (42.5 %) LN stations. 24 (21.1 %) patients underwent salvage radiation therapy (RT), and 44 (38.6 %) patients underwent palliative treatment. Better OS was observed in the salvage RT group (p = 0.025). The 1-year PFS and OS rates were 27.7 % and 55.2 %, respectively, with salvage RT, 14.0 % and 39.9 %, respectively, with palliative treatment, and 22.8 % and 26.8 %, respectively, with no additional treatment. Multivariate analysis showed that salvage RT (PFS, HR 0.463, p = 0.050; OS, HR 0.312, p = 0.002), palliative treatment (PFS, HR 0.436, p = 0.013; OS, HR 0.553, p = 0.050), and simultaneous distant metastasis (PFS, HR 2.335, p = 0.005; OS, HR 1.726, p = 0.054) affected clinical outcomes.

Conclusion:
Many cases of regional LN recurrence are confined to the locoregional area of patients, and appropriate treatment can improve the prognosis of these patients.
Keimyung Author(s)(Kor)
김진희
Publisher
School of Medicine (의과대학)
Type
Article
ISSN
1879-0887
Source
https://www.clinicalkey.com/#!/content/playContent/1-s2.0-S016781402300110X
DOI
10.1016/j.radonc.2023.109572
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/45111
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학)
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