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Vienna, Austria

ESTRO 2023

Session Item

Monday
May 15
16:30 - 17:30
Business Suite 1-2
Lung 2
Cécile Le Péchoux, France
Poster Discussion
Clinical
Patterns of recurrence, treatment, and outcome of lymph node recurrence after SBRT for lung cancer
Hyunju Shin, Korea Republic of
PD-0966

Abstract

Patterns of recurrence, treatment, and outcome of lymph node recurrence after SBRT for lung cancer
Authors:

Tae Hoon Lee1, Hyunju Shin2, Yong Chan Ahn2, Min Kyu Kang3, Changhoon Song4, Woo Chul Kim5, Sung Ho Moon6, Jin Hee Kim7, Jaeho Cho8, Hae Jin Park9, Hee Kwan Lee10, Byoung Hyuck Kim11, Hak Jae Kim1

1Seoul National University Hospital, Department of Radiation Oncology, Seoul, Korea Republic of; 2Samsung Medical Center, Department of Radiation Oncology, Seoul, Korea Republic of; 3Kyungpook National University School of Medicine, Department of Radiation Oncology, Daegu, Korea Republic of; 4Seoul National University Bundang Hospital, Department of Radiation Oncology, Seongnam, Korea Republic of; 5Inha University Hospital, Department of Radiation Oncology, Incheon, Korea Republic of; 6National Cancer Center, Proton Therapy Center, Goyang, Korea Republic of; 7Dongsan Medical Center, Department of Radiation Oncology, Daegu, Korea Republic of; 8Yonsei Cancer Center, Department of Radiation Oncology, Seoul, Korea Republic of; 9Hanyang University Hospital, Department of Radiation Oncology, Seoul, Korea Republic of; 10Jeonju Jesus Hospital, Department of Radiation Oncology, Jeonju, Korea Republic of; 11Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Department of Radiation Oncology, Seoul, Korea Republic of

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Purpose or Objective

To report multi-institutional data of patterns of recurrence, treatment approach, and clinical outcomes for regional lymph node (LN) recurrence after stereotactic body radiation therapy (SBRT) for primary lung cancer.

Material and Methods

Medical records of 114 patients who experienced regional LN recurrence as the first recurrence after lung SBRT were retrospectively reviewed. Patterns of recurrence was classified as local recurrence, regional recurrence, and distant metastasis. Types of additional treatment was recorded. Clinical outcomes including progression-free survival (PFS) and overall survival (OS) were analyzed.

Results

Half of the patients had regional LN recurrence only. The most frequent simultaneous recurrence was distant metastasis (38.6%). Common site of regional recurrence was ipsilateral hilar (47.2%), ipsilateral upper mediastinal (40.6%), and subcarinal (42.5%) LN station. Detailed sites of LN recurrence in 106 analyzable patients are illustrated in the following figure. 24 (21.1%) patients underwent salvage radiation therapy (RT), and 44 (38.6%) patients underwent palliative treatment. Better OS was reported in salvage RT group (P = 0.025). 1-year PFS and OS were 27.7% and 55.2% with salvage RT, 14.0% and 39.9% with palliative treatment, and 22.8% and 26.8% with no additional treatment, respectively. Multivariate analysis showed that salvage RT (PFS, HR 0.463, P = 0.050; OS, HR 0.312, P = 0.002), palliative treatment (PFS, HR 0.436, P = 0.013; OS, HR 0.553, P = 0.050) and simultaneous distant metastasis (PFS, HR 2.335, P = 0.005; OS, HR 1.726, P = 0.054) were associated with clinical outcomes.


Conclusion

Many regional LN recurrence still confined in locoregional extent, and appropriate treatment can improve the prognosis of these patients.