Abstract
Introduction: Stereotactic body radiotherapy (SBRT) has been proposed as an alternative to surgical resection for primary and metastatic lung cancers, for patients under inoperable condition based on poor lung function and/or senility. Sometimes, such patients refuse surgery and chose SBRT for the first treatment as a less invasive therapeutic option. However, surgical outcomes for local recurrence after SBRT were still unclear.
Methods: To further understand the indication for salvage lung resection, we retrospectively reviewed 9 patients (3 with stageInon-small cell lung cancer and 6 with metastatic lung tumors) who underwent salvage surgical resection for local recurrence after SBRT.
Results: Of the 9 patients, 7 underwent lobectomy, and the remaining 2 did bilobectomy and segmentectomy, respectively. 2 with metastatic lung tumors had pleural adhesion resulted from SBRT-related fibrosis. However, there was no case in which SBRT made surgical procedure impossible. Retrospectively considering the course after SBRT, once all 9 irradiated tumors resulted in disease progression, they grew in size rapidly.
Conclusions: We have treated all patients without major technical difficulties by SBRT-related change. SBRT did not close the door to perform salvage surgical resection, and surgical resection might be feasible for local recurrence after SBRT. However, close follow-ups are mandatory for patients treated with SBRT because tumor regrowth after SBRT is thought to occur at a rapid rate. And if patients are medically fit for surgery as the first line treatment, the use of SBRT should not be decided by only reason of its less invasiveness.
- © 2011 ERS