Salvage lung SBRT may be a curative option after lobectomy

Area of Science:

• Oncology
• Radiation Oncology
• Thoracic Surgery

Background:

• Stereotactic body radiotherapy (SBRT) is an established treatment for early-stage non-small cell lung cancer (NSCLC).
• Salvage SBRT after primary surgery is an emerging strategy for recurrent or residual disease.
• Comparing SBRT as a primary modality versus salvage treatment is crucial for treatment optimization.

Purpose of the Study:

• To evaluate the feasibility and outcomes of SBRT as a salvage treatment for lung cancer post-surgery.
• To compare these outcomes with SBRT used as an initial treatment for NSCLC.
• To assess the safety and efficacy of salvage SBRT in a real-world patient cohort.

Main Methods:

• Retrospective analysis of early-stage NSCLC patients treated with SBRT between January 2017 and January 2022.
• Patients were categorized into primary SBRT and salvage SBRT groups.
• Clinical outcomes including overall survival, local control, and toxicity were analyzed.

Main Results:

• 68 patients were analyzed; 10% received salvage SBRT after prior surgery.
• Salvage SBRT treated predominantly central lesions, while primary SBRT focused on peripheral ones.
• Overall survival and local control rates were comparable between groups (2-year OS: 73.5%).
• Late grade 3-4 pneumonitis occurred in 8.2% of patients, primarily in the primary SBRT group.

Conclusions:

• SBRT as a salvage treatment following primary lung cancer surgery is feasible and demonstrates an acceptable safety profile.
• The oncological outcomes of salvage SBRT appear equivalent to those achieved with primary SBRT.
• Salvage SBRT represents a viable treatment option for select patients who have undergone prior surgery.