Salvage chemoradiotherapy with cisplatin and vinorelbine for postoperative locoregional recurrence of non-small cell lung cancer

Abstract

Although a few investigators have demonstrated the effect of concurrent chemoradiotherapy (CRT) for postoperative recurrent non-small cell lung cancer (NSCLC), the outcome of this treatment remains unclear. The aim of this study was to elucidate the efficacy and tolerability of concurrent CRT with cisplatin (CDDP) and vinorelbine (VNR) in patients with postoperative locoregional recurrent NSCLC. A total of 40 patients who had received concurrent CRT with CDDP and VNR between January 1999 and December 2014 were retrospectively analyzed. Patients were treated with CDDP (80 mg/m2 on day 1) and VNR (20 mg/m2 on days 1 and 8) every 4 weeks. Radiotherapy was administered concurrently during cycle 1. The delivered x-ray radiation dose was 60 Gy in all 37 patients who received x-ray radiotherapy; 3 patients received proton beam radiation (66 Gy [RBE] in 1 patient and 60 Gy [RBE] in 2 patients). The objective response rate was 85% (95% confidence interval [CI], 70.9%–92.9%). The median progression-free survival was 20.3 months (95% CI, 12.9 months–not reached). The 2-year survival rate was 78.9% (95% CI, 63.0%–89.1%). The most common grade ≥3 toxicity was neutropenia (18%). No grade ≥3 radiation pneumonitis and no treatment-related deaths were observed.Our study revealed that concurrent CRT with CDDP and VNR was active and safe for patients with postoperative locoregional recurrent NSCLC. Salvage CRT for postoperative locoregional recurrent NSCLC might be a promising treatment for selected patients.

WITHDRAWN: Correlation between DVH parameters and lung function changes before and after radiotherapy and the occurrence of radiation-induced lung injury (RILI)

“…With the emergence of three-dimensional conformal radiotherapy and threedimensional conformal intensity-modulated radiotherapy, the incidence of radiation pneumonitis has decreased compared with the previous. However, the data show that radiation pneumonitis with clinical symptoms occurred 7% -32%, severe radiation pneumonitis occurred 2.6% -18.0%, and death occurred 0-2% [31][32][33]. The occurrence of radiation pneumonitis reduces the patient's quality of life and even endangers the patient's life.…”

Survival Outcomes of Salvage Therapy for Local and Regionally Recurrent NSCLC

“…The exact incidence varies depending on the stage at diagnosis and type of initial curative therapy received; however, it is reported to range from 5% to 15%. [3][4][5][6][7][8] There is limited prospective evidence available to guide the treatment of locoregionally recurrent NSCLC. Patients with isolated pulmonary relapse can be treated with further local therapies, such as a surgical procedure or stereotactic radiosurgery (SRS).…”

Salvage Photon or Proton Radiotherapy for Oligo-recurrence in Regional Lymph Nodes After Surgery for Non-small Cell Lung Cancer

“…The use of concurrent chemotherapy was associated with RC, but not OS or PFS. Although the advantage of using concurrent chemotherapy with RT has not been established, some studies reported that concurrent chemotherapy tended to improve OS and PFS rates in NSCLC patients with postoperative oligo-recurrence in the mediastinal lymph nodes (22,25,33,34). Imai et al reported that concurrent chemoradiotherapy resulted in a significantly longer PFS compared with RT alone (median survival: 19.0 vs. 12.5 months) (25).…”