PURPOSE: To report local control and overall survival following salvage robotic radiosurgery for conventionally irradiated locally recurrent central NSCLC patients.
METHODS: Patients presenting with localized recurrent central NSCLC within previously treated conventional radiation fields salvaged using the CyberKnife system with tumor tracking were retrospectively reviewed. Primary tumors were considered central if they predominately involved the superior sulcus, mediastinum or hilum.
RESULTS: Twenty patients were treated over a 7 year period. A cumulative dose of 21 to 50 Gy was delivered to the gross tumor volume in 3-5 fractions. At a mean follow-up of 15 months, the 1-year Kaplan-Meier local control and overall survival estimates were poor at 42% and 39%, respectively. However, 1-year Kaplan-Meier local control and overall survival were improved at 50% and 100% when doses greater than 30 Gy were delivered. Severe toxicities included 1 patient experiencing grade II soft tissue radiation fibrosis.
CONCLUSIONS: Robotic radiosurgery is a novel salvage treatment option for locally recurrent central NSCLC patients following conventional irradiation. Dose escalation with clinical experience resulted in improved local control and overall survival rates.
CLINICAL IMPLICATIONS: Robotic radiosurgery is a novel salvage treatment option for locally recurrent central NSCLC patients following conventional irradiation.
DISCLOSURE: Brian Collins: Consultant fee, speaker bureau, advisory committee, etc.: Consulted for Accuray
The following authors have nothing to disclose: Christopher DeCotiis, Eric Oermann, Margaux Wooster, Jennifer Rabin, Simeng Suy, Sean Collins, Xia Yu, Eric Anderson
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