Stereotactic Body Radiation Therapy with Helical-Tomotherapy for Medical Inoperable Early Stages (I-IIIa) Primary and Second-Primary NSCLC:Outcomes of the One-Year Experience and Analysis of Toxicities

Abstract

Introduction: To presents the outcomes of our technique for medically inoperable both primary and secondprimary (SPLC) early stages non-small-cell lung cancer and to integrate the possibility of organising pneumonia (OP) within the irradiation field (IF) by the analysis of radiological changes. Materials and Methods: Retrospective analysis after the one-year (2011-2012) experience in our hospital. Seventeen patients were treated with the same delivery plan using tomotherapy as a total dose of 60 Gy in 5 fractions. Outcomes and toxicities were recorded and, for SPLC, were described separately. A single radiologist reviewed computed tomography scans. Results: Sixteen patients were included; five primary lung malignancies (31.3%), 10 SPLC (62.5%) and 1 isolated mediastinal metastasis of lung cancer (6.2%). A pathological proof was obtained for 72.2% of all lesions. The median radiological follow-up was 11.0 (10.5 months for SPLC). For all cases the 6and 12-months survival rates were 100% and 77.7% (100% and 71.4% for SPLC), and the 6and 12months loco-regional control rates counted both for (similarly to SPLC) 100%. Two of 16 patients developed grade 3 late transient (after steroids therapy) radiation pneumonitis and one presented asymptomatic infiltrates as comparable to OP opacities. Conclusions: The T-SBRT was safe and effective. Mild OP could probably be associated to radiation-induced anomalies into the IF and the knowledge of the possibility of migrating opacities, could help to discern relapse to radiation-induced opacities.