Treatment of multiple primary lung cancers using stereotactic radiotherapy, either with or without surgery
Abstract
Background and purpose Multiple primary lung cancers (MPLC) are not an uncommon presentation. Current guidelines recommend a curative approach when early-stage MPLC is diagnosed as favorable outcomes have been reported after surgery. We studied outcomes following stereotactic ablative radiotherapy (SABR).Materials and methods Following review of imaging and pathology at a multi-disciplinary tumor board, a total of 62 patients were referred for SABR with a diagnosis of synchronous MPLC. SABR was performed for both lesions in 56 patients, while another 6 underwent SABR for only one lesion and surgery for the other lesion. A total dose of 54-60 Gy was delivered in 3-8 fractions.Results Median follow-up was 44 months (95% CI: 29-59). Overall survival of all patients was 31 months (95% CI: 17-44), with an actuarial 2-year survival of 56%. No grade 4 or 5 post-SABR toxicity was observed. Local control rates calculated per lesion, were 84% at 2 years, and 78% at 3 years. The two-year actuarial regional control rate was 87%.Conclusions SABR for synchronous MPLC achieves a lesion control rate of 84% after 2 years, with limited toxicity. SABR should be considered when patients with lung cancer present with a synchronous second lesion and no nodal involvement.
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Surgery and stereotactic radiosurgery have been shown to produce long-term survivors in patients with a solitary lesion in the contralateral lung.
“Both surgery [169, 170] and SRS [171, 172] have been shown to result in long-term survivors in this setting [IV, B].”
From Metastatic non-small-cell lung cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up (2016) · cites this paper as [171]
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Novello, S., Barlesi, F., Califano, R., Cufer, T., Ekman, S., Levra, M. G., Kerr, K., Popat, S., Reck, M., Senan, S., et al. (2016) · Annals of Oncology · doi:10.1093/annonc/mdw326 · Cited by 2,631 · see citing works
Self-citation
- Authors
- Griffioen, G. H. M. J., Lagerwaard, F. J., Haasbeek, C. J. A., Smit, E. F., Slotman, B. J., & Senan, S.
- Affiliations
- Amsterdam UMC Location Vrije Universiteit Amsterdam (NL)
- Corresponding author
- Lagerwaard, Frank J.
- Venue
- Radiotherapy and Oncology
- Publisher
- Elsevier BV
- Published
- 2013-06
- Volume
- 107
- Issue
- 3
- Pages
- 403-408
- ISSN
- 0167-8140 (ISSN-L)
- OpenAlex
- W2047551490
- Cited by
- 59
- References
- 25
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 2 · 2023: 9 · 2022: 5 · 2021: 3 · 2020: 5 · 2019: 5 · 2018: 9 · 2017: 4 · 2016: 4 · 2015: 3 · 2014: 4 · 2013: 2
- FWCI
- 3.53
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Radiotherapy and Oncology (publishedVersion)
- PubMed (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Diagnosis and Treatment
- Health Sciences › Medicine › Epidemiology › Multiple and Secondary Primary Cancers
- Physical Sciences › Physics and Astronomy › Radiation › Advanced Radiotherapy Techniques
- Keywords
- multiple primary lung cancer, synchronous lung tumors, stereotactic body radiotherapy, lung cancer surgery, local control, overall survival, regional control, treatment toxicity, curative treatment
- MeSH terms
- Aged, Aged, 80 and over, Female, Humans, Lung Neoplasms, Male, Middle Aged, Neoplasms, Multiple Primary, Radiotherapy Dosage, Tomography, X-Ray Computed, Radiosurgery
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