Lung Cancer. 2012 Jul;77(1):140-5. doi: 10.1016/j.lungcan.2012.02.018. Epub 2012 Mar 23.

Re-irradiation plus regional hyperthermia for recurrent non-small cell lung cancer: a potential modality for inducing long-term survival in selected patients.

Ohguri T, Imada H, Yahara K, Moon SD, Yamaguchi S, Yatera K, Mukae H, Hanagiri T, Tanaka F, Korogi Y.

Source

Department of Radiology, University of Occupational and Environmental Health, Kitakyushu, Japan. ogurieye@med.uoeh-u.ac.jp

Abstract

PURPOSE:

The purpose of this study was to assess the toxicity and efficacy of re-irradiation plus regional hyperthermia for recurrent NSCLC and to identify the predictors of long-term survival.

METHODS AND MATERIALS:

A total of 33 patients with recurrent NSCLC treated with re-irradiation plus regional hyperthermia were retrospectively analyzed. The median total dose of initial radiotherapy and re-irradiation were 70 Gy and 50 Gy, respectively. A median of 5 hyperthermia treatments using an 8-MHz radiofrequency-capacitive device were applied during re-irradiation in all patients.

RESULTS:

Toxicity of Grade 3 was seen in 3 (9%) patients, and no Grade 4 or 5 toxicity was observed. The median overall survival, local control, and disease progression-free survival times after re-irradiation were 18.1, 12.1, and 6.7 months, respectively. Eight patients achieved a long-term survival (more than 3 years after re-irradiation), and 4 of them underwent a third round of irradiation for re-recurrent tumors. Univariate analyses showed that a smaller tumor size (<4 cm) and the absence of distant metastases were significant predictors for a better overall survival. The absence of distant metastases was also found to be a significant predictor for better disease progression-free survival in the univariate analyses. In the subset analyses of 23 patients treated withhyperthermia using electrodes of 30 cm in diameter, the use of a higher radiofrequency-output power tended to be associated with a better prognosis in terms of the local control rate.

CONCLUSIONS:

Re-irradiation plus regional hyperthermia for recurrent NSCLC appears feasible, with acceptable toxicity, and may be a promisingtreatment that can result in the long-term survival of patients without distant metastasis and larger recurrent tumors.