Features of late local failure of early‑stage non‑small cell lung cancer treated with stereotactic body radiotherapy

Makita,Kenji; Hamamoto,Yasushi; Kanzaki,Hiromitsu; Nagasaki,Kei; Ueno,Tsuyoshi; Shigematsu,Hisayuki; Harada,Daijiro; Ninomiya,Takashi; Kato,Yuka; Sugawara,Yoshifumi; Kozuki,Toshiyuki; Yamashita,Motohiro

doi:10.3892/ol.2024.14794

Features of late local failure of early‑stage non‑small cell lung cancer treated with stereotactic body radiotherapy

Authors:
- Kenji Makita
- Yasushi Hamamoto
- Hiromitsu Kanzaki
- Kei Nagasaki
- Tsuyoshi Ueno
- Hisayuki Shigematsu
- Daijiro Harada
- Takashi Ninomiya
- Yuka Kato
- Yoshifumi Sugawara
- Toshiyuki Kozuki
- Motohiro Yamashita
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Affiliations: Department of Radiation Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Ehime 791‑0280, Japan, Department of Thoracic Surgery, National Hospital Organization Shikoku Cancer Center, Matsuyama, Ehime 791‑0280, Japan, Department of Thoracic Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Ehime 791‑0280, Japan, Department of Diagnostic Radiology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Ehime 791‑0280, Japan
Published online on: November 8, 2024 https://doi.org/10.3892/ol.2024.14794
Article Number: 48
Copyright: © Makita et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Local failure of non‑small cell lung cancer (NSCLC) treated with stereotactic body radiation therapy (SBRT) often occurs within 2 years and delayed local failure is uncommon. In the present study, features of late local failure (LLF; >2 years after SBRT) after SBRT were investigated and compared with those of early local failure (ELF; ≤2 years after SBRT) to explore whether these two local recurrence features have different prognostic implications. Patients who underwent SBRT for stage I‑IIA NSCLC between July 2006 and March 2014 were retrospectively reviewed. Overall, 173 patients underwent SBRT for NSCLC. The median follow‑up times after SBRT were 50 and 31 months for survival and computed tomography (CT) follow‑up, respectively. LLF and ELF occurred in 7 and 13 patients, respectively. The median times to LLF and ELF were 42 months (range, 31‑61 months) and 13 months (range, 4‑16 months), respectively. Local‑only failure occurred in 14% (1/7) of LLF cases and 77% (10/13) of ELF cases, which was significantly different (Fisher's exact test, P=0.02). Curative‑intent salvage treatment was impossible in all of the LLF cases and 69% (9/13) of the ELF cases, which was significantly different (Fisher's exact test, P<0.01). The median survival times after local failure were 9 and 25 months for patients with LLF and ELF, respectively. Additionally, the 1‑year overall survival rates after local failure were 29 and 83% in the LLF and ELF groups, respectively, which was significantly different (log‑rank test, P<0.01 at 1‑year). In summary, the prognosis after LLF was significantly unfavorable compared with after ELF. Curative‑intent salvage treatment is often difficult for LLF due to metastases. Therefore, it seems reasonable to decrease the frequency of follow‑up CT for detecting tumor recurrence after the first 2 years post‑SBRT.

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