Available Evidence on Re-Irradiation with Stereotactic Ablative Radiotherapy Following High-dose Previous Thoracic Radiotherapy for Lung Malignancies
Cet article passe en revue les études concernant l'efficacité et la toxicité d'une radiothérapie ablative stéréotaxique pour traiter une tumeur du poumon ayant récidivé après une radiothérapie thoracique à haute dose de rayonnements ionisants
Patients affected with intra-thoracic recurrences of primary or secondary lung malignancies after a first course of definitive radiotherapy have limited therapeutic options, and they are often treated with a palliative intent. Re-irradiation with stereotactic ablative radiotherapy (SABR) represents an appealing approach, due to the optimized dose distribution that allows for high-dose delivery with better sparing of organs at risk. This strategy has the goal of long-term control and even cure. Aim of this review is to report and discuss published data on re-irradiation with SABR in terms of efficacy and toxicity. Results indicate that thoracic re-irradiation may offer satisfactory disease control in selected patients, however the data on outcome and toxicity are derived from low quality retrospective studies, and results should be cautiously interpreted. SABR may also be associated with serious toxicity, and attention should be paid for an accurate patients’ selection.