Dosimetric Factors and Toxicity in Highly Conformal Thoracic Reirradiation

International Journal of Radiation Oncology, Biology, Physics
Michael S BinkleyDavid Benjamin Shultz

Abstract

We determined cumulative dose to critical structures, rates of toxicity, and outcomes following thoracic reirradiation. We retrospectively reviewed our institutional database for patients treated between 2008 and 2014, who received thoracic reirradiation with overlap of 25% prescribed isodose lines. Patients received courses of hyperfractionated (n=5), hypofractionated (n=5), conventionally fractionated (n=21), or stereotactic ablative radiation therapy (n=51). Doses to critical structures were converted to biologically effective dose, expressed as 2 Gy per fraction equivalent dose (EQD2; α/β = 2 for spinal cord; α/β = 3 for other critical structures). We identified 82 courses (44 for retreatment) in 38 patients reirradiated at a median 16 months (range: 1-71 months) following initial RT. Median follow-up was 17 months (range: 3-57 months). Twelve- and 24-month overall survival rates were 79.6% and 57.3%, respectively. Eighteen patients received reirradiation for locoregionally recurrent non-small cell lung cancer with 12-month rates of local failure and regional recurrence and distant metastases rates of 13.5%, 8.1%, and 15.6%, respectively. Critical structures receiving ≥75 Gy EQD2 included spinal cord (1 cm(3); n=1), esophag...Continue Reading

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Citations

Oct 30, 2018·Journal of Applied Clinical Medical Physics·Nevin McVicarAlanah Bergman
Apr 21, 2017·Strahlentherapie und Onkologie : Organ der Deutschen Röntgengesellschaft ... [et al]·Carsten NiederArjun Sahgal
Feb 22, 2021·Seminars in Radiation Oncology·Benjamin HunterAhmed Salem
Jun 3, 2021·Current Oncology·Brane GrambozovFranz Zehentmayr

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