Salvage lung SBRT may be a curative option after lobectomy

This study intends to analyze the feasibility and the outcomes of stereotactic body radiotherapy (SBRT) as a salvage treatment for lung cancer after primary surgery and compare them with the results of SBRT as the first treatment option.

Retrospective analysis of early-stage non-small cell lung cancer (NSCLC) treated with SBRT, either as a primary treatment or as salvage treatment after primary surgery.

From January 2017 to January 2022, 68 patients were analyzed. 80% were 65 years-old or above. Seven (10%) underwent SBRT as a salvage treatment after primary surgery. Most lesions treated with primary SBRT were peripheral (n = 33; 54.1%), opposed to the salvage group, where 71.4% were central lesions (n = 5). Patients who had previous surgery presented with lower forced expiratory volume in 1 second (FEV1) (p = 0.006). Median time between surgery and salvage SBRT was 35.4 months. Median follow-up was 29.3 months; median overall survival (OS) at 2 years and 3 years was, respectively, 73.5% and 67.6% (median 52.5 months), with no difference between groups. Median local, regional, and distant progression free survivals were not reached. Local control was 94.1% at 2 years and 92.6% at 3 years. Only 5 (8.2%) patients presented late grade 3-4 pneumonitis, and one, grade 5 (fatal), all in the primary SBRT group.

SBRT as salvage after primary surgery is feasible and seems to be safe. Outcomes are expected to be equivalent to those of the patients submitted to primary SBRT.