Abstract
Evidence on the use of repeated stereotactic body radiotherapy (SBRT) is limited. We investigated the efficacy of repeated SBRT and predictors of lung toxicity. We reviewed 20 patients (27 lesions) with primary or metastatic lung cancer who underwent repeated SBRT with CyberKnife® We generated a composite plan for dosimetric analysis based on equivalent doses in 2.0-Gy fractions (α/β=3). Predictors of Grade 2+ radiation pneumonitis (RP) were examined. The median follow-up duration was 18.0 months. The 1-year and 2-year local control were both 95.2%. Five patients (25%) developed Grade 2+ RP, including a Grade 5 RP. The Grade 2+ RP group showed higher composite mean lung dose (MLD) and lower lung volumes spared from 5-20 Gy (VS5-VS20). Repeated SBRT with CyberKnife® showed favorable local control, but a high rate of Grade 2+ RP. Accumulated MLD and VS5-VS20 may predict RP.
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