Top Line: Unfortunately, locoregional recurrence of lung cancer is not uncommon, and reirradiation can be a challenging endeavor.
The Study: This retrospective study took a look back at 130 patients who received definitive reirradiation for locoregionally recurrent NSCLC. It specifically included those who received conventional fractionation due to geometric overlap with a prior treatment volume. Prescription doses ranged from 60-72 Gy at 1.8-2 Gy per fraction using either protons(88%) or photons. Median time since initial RT was 19.5 months. Most (83%) received concurrent chemo, and 20% also received immunotherapy. The median OS was 17.4 months, and median PFS was 8.1 months. OS at 2 years was 37.8%, and the rate of distant failure at that time point was 40% with a locoregional failure rate of 44%. Not unexpectedly, those who received immunotherapy had superior locoregional control and OS. The rate of grade 3+ toxicity was 26.7%, and the rate of grade 5 toxicity was 6.9%. Among the grade 5 events, 44% involved airway fistula or rupture.
TBL: In this retrospective study of (mostly proton) reirradiation for locoregionally recurrent NSCLC, high grade toxicity was relatively limited, and incorporation of immunotherapy was associated with better outcomes. | Rochetti, Radiother Oncol 2025
The Study: This retrospective study took a look back at 130 patients who received definitive reirradiation for locoregionally recurrent NSCLC. It specifically included those who received conventional fractionation due to geometric overlap with a prior treatment volume. Prescription doses ranged from 60-72 Gy at 1.8-2 Gy per fraction using either protons(88%) or photons. Median time since initial RT was 19.5 months. Most (83%) received concurrent chemo, and 20% also received immunotherapy. The median OS was 17.4 months, and median PFS was 8.1 months. OS at 2 years was 37.8%, and the rate of distant failure at that time point was 40% with a locoregional failure rate of 44%. Not unexpectedly, those who received immunotherapy had superior locoregional control and OS. The rate of grade 3+ toxicity was 26.7%, and the rate of grade 5 toxicity was 6.9%. Among the grade 5 events, 44% involved airway fistula or rupture.
TBL: In this retrospective study of (mostly proton) reirradiation for locoregionally recurrent NSCLC, high grade toxicity was relatively limited, and incorporation of immunotherapy was associated with better outcomes. | Rochetti, Radiother Oncol 2025