TY - JOUR
T1 - Review of thoracic reirradiation with stereotactic body radiation therapy
T2 - A focus on toxicity risks
AU - Milano, Michael T.
AU - Mihai, Alina
AU - Kong, Feng Ming (Spring)
N1 - Publisher Copyright:
© 2018 American Society for Radiation Oncology
PY - 2018/7/1
Y1 - 2018/7/1
N2 - Reirradiation of thoracic malignancies is clinically challenging in balancing the risks and efficacy. Stereotactic body radiation therapy (SBRT) can facilitate ablative dosing of discrete targets while minimizing normal tissue exposure; thus, SBRT is an attractive, minimally invasive option to consider for patients with recurrent or new malignancies within a previously irradiated field. Published data are summarized from 28 studies on the use of SBRT for thoracic reirradiation. We review clinical outcomes with a primary focus on toxicity risks, dosimetric correlates of normal tissue complication probability (NTCP), and other factors that correlate with NTCP. Meaningful compilation of published data on reirradiation with SBRT is limited because of the retrospective nature of published studies, which include mostly small numbers of patients, with various clinical scenarios and SBRT dosing and techniques. Nevertheless, these studies show that thoracic reirradiation with SBRT is feasible, with relatively favorable outcomes. Yet, severe to fatal toxicities do occur, and dosimetric measures to predict severe toxicity are poorly characterized, necessitating further study to better characterize predictive factors for NTCP.
AB - Reirradiation of thoracic malignancies is clinically challenging in balancing the risks and efficacy. Stereotactic body radiation therapy (SBRT) can facilitate ablative dosing of discrete targets while minimizing normal tissue exposure; thus, SBRT is an attractive, minimally invasive option to consider for patients with recurrent or new malignancies within a previously irradiated field. Published data are summarized from 28 studies on the use of SBRT for thoracic reirradiation. We review clinical outcomes with a primary focus on toxicity risks, dosimetric correlates of normal tissue complication probability (NTCP), and other factors that correlate with NTCP. Meaningful compilation of published data on reirradiation with SBRT is limited because of the retrospective nature of published studies, which include mostly small numbers of patients, with various clinical scenarios and SBRT dosing and techniques. Nevertheless, these studies show that thoracic reirradiation with SBRT is feasible, with relatively favorable outcomes. Yet, severe to fatal toxicities do occur, and dosimetric measures to predict severe toxicity are poorly characterized, necessitating further study to better characterize predictive factors for NTCP.
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U2 - 10.1016/j.prro.2018.01.008
DO - 10.1016/j.prro.2018.01.008
M3 - Review article
AN - SCOPUS:85046169985
SN - 1879-8500
VL - 8
SP - 251
EP - 265
JO - Practical Radiation Oncology
JF - Practical Radiation Oncology
IS - 4
ER -