Purpose To evaluate prospectively the efficacy, toxicity, and duration of the palliative effect of retreatment with external beam radiotherapy in symptomatic patients with recurrent non-small-cell lung cancer. Methods and materials Twenty-eight symptomatic patients with local recurrence of non-small-cell lung cancer underwent repeated treatment after previous radiotherapy (equivalent dose, 46-60 Gy). Reirradiation consisted of two fractions of 8 Gy on Days 1 and 8 with two opposed beams using 6-18-MV photon beams at the site of pulmonary recurrence. The physician scored symptom resolution. Results Relief of hemoptysis and superior vena cava syndrome could be obtained in all assessable cases (100%). Treatment was less effective for coughing (67%) and dyspnea (35%). The overall median duration of this palliative effect was 4 months. Palliation in almost all patients lasted more than one-half of their remaining life span. The Karnofsky performance score improved in 45% of assessable cases. One patient had Grade 2 esophagitis. Complications consisted of tumor-related fatal hemoptysis in 5 patients (17%) and 1 death from bronchoesophageal fistula (4%). Conclusion External beam hypofractionated reirradiation can be effective as a palliative treatment for local complaints in non-small-cell lung cancer. The complication rate of reirradiation was acceptably low.

Non-small-cell lung cancer, Palliation, Radiotherapy, Repeated RT
dx.doi.org/10.1016/j.ijrobp.2003.09.087, hdl.handle.net/1765/63510
International Journal of Radiation: Oncology - Biology - Physics
Department of Pulmonology

Kramer, G.W.P.M, Gans, S, Ullmann, E.F, van Meerbeeck, J.P, Legrand, C, & Leer, J-W.H. (2004). Hypofractionated external beam radiotherapy as retreatment for symptomatic non-small-cell lung carcinoma: An effective treatment?. International Journal of Radiation: Oncology - Biology - Physics, 58(5), 1388–1393. doi:10.1016/j.ijrobp.2003.09.087