NACİYE IŞIK, GÖKHAN YAPRAK, CENGİZ GEMİCİ, ÖZÜM ATASOY
Turkish Journal of Oncology - 2020;35(2):199-205
OBJECTIVE Brain metastasis can be seen in small cell lung cancer patients despite cranial radiotherapy. In case of intracranial recurrence after cranial radiotherapy, treatment choices are restricted. Cranial reirradiation may be an option. In our study, the role of stereotactic radiotherapy after relapse in patients undergoing whole-brain radiotherapy for prophylaxis or metastasis was investigated. METHODS Thirty-six small cell lung cancer patients who had intracranial recurrence after total cranial irradiation and who were treated with salvage SRT in our clinic between June 2010 and January 2019 were evaluated retrospectively in this study. The patients were treated using a frameless robotic radiosurgery system (CyberKnife-Accuray, CA, USA). Median 20 Gy (10-24 Gy) was administered in one to four fractions depending on the volume and relation of the tumor with critical structures. RESULTS Whole-brain radiotherapy was performed with cranial prophylaxis in 16 patients (44.5%) and brain metastasis in 20 patients (55.5%), in which patients underwent stereotactic radiotherapy (SRT) with recurrence/metastasis. Median follow-up time after SRT was 5.5 months. Median one and two years survival after SRT were %33 and %6, 6, and median survival was 4, 1 months. After SRT, one and twoyear cranial control rates were 57% and 15%, and the median cranial control duration was 12.8 months. In multivariate analysis, the only time interval between WBRT and SRT was found to be significant for survival after SRT p=0.014 (HR: 2.66 95% CI:1.21-5.82). CONCLUSION SRT should be considered as a treatment alternative, especially in patients with long time intracranial control after whole-brain radiotherapy and in patients with systemic disease control.
