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Efficacy and toxicity of hyperfractionated thoracic reirradiation.

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Efficacy and toxicity of hyperfractionated thoracic reirradiation. Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology Butler, S. S., Raclin, T., Lau, B., Raja, N., Skinner, L., Kastelowitz, N., Chin, A. L., Diehn, M., Loo, B. W., Vitzthum, L. K. 2025: 111001

Abstract

Hyperfractionated reirradiation (re-RT) has been shown to mitigate late toxicity for some cancers, but data on safety and efficacy for thoracic tumors are limited.We evaluated a cohort of 28 consecutive cases among 25 patients treated with re-RT to either primary or metastatic thoracic tumors, using 60?Gy in 50 fractions delivered twice daily. Incidence rates of toxicity, local recurrence (LR), and any disease progression were evaluated using competing risk analysis. Cumulative dose to organs at risk (OARs) was calculated (EQD2 [alpha/beta?=?3]), correlated with toxicity outcomes, and compared to published constraints for re-RT.There was direct overlap of 100?% isodose lines between treatment courses in 90.5?% of cases. Most patients had tumors abutting the proximal bronchial tree (PBT, 89?%). The median re-RT PTV volume was 67?cm3. The overall rate of?=G2 toxicity was 46?% and the rate of?=?G3 toxicity was 15?%. The rate of local recurrence and overall survival at 12?months was 33?% and 80?%, respectively. The lung volume receiving a cumulative dose of 20?Gy was kept under 40?% (V20 Gy?

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