Stereotactic Pelvic Reirradiation for Locoregional Cancer Relapse

Up to 40% of patients who have received radiation for a pelvic malignancy will develop locoregional recurrence in the previously irradiated volume. Stereotactic body radiotherapy (SBRT) has been used in the oligometastatic setting, and provides an ablative approach ideal for reirradiation. The purpo...

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Bibliographic Details
Published in:Clinical oncology (Royal College of Radiologists (Great Britain)) 2021-01, Vol.33 (1), p.e15-e21
Main Authors: Kinj, R., Doyen, J., Hannoun-Lévi, J.M., Naghavi, A.O., Chand, M.E., Baudin, G., Ferrero, J.M., François, E., Evesque, L., Borchiellini, D., Benezery, K., Bondiau, P.Y.
Format: Article
Language:English
Subjects:
Pelvic radiotherapy
pelvic reirradiation
reirradiation
stereotactic radiotherapy
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Summary:Up to 40% of patients who have received radiation for a pelvic malignancy will develop locoregional recurrence in the previously irradiated volume. Stereotactic body radiotherapy (SBRT) has been used in the oligometastatic setting, and provides an ablative approach ideal for reirradiation. The purpose of this study was to evaluate the outcomes after SBRT reirradiation of extraosseous recurrences in the pelvis. This single institution retrospective study evaluated patients treated with SBRT reirradiation in the pelvis from January 2011 to February 2018. Patients with more than five oligometastatic lesions, >7 cm in size, and recurrence within the prostate were excluded. In total, 30 patients were treated with SBRT with a median follow-up of 29.4 months. The primary tumour sites were most commonly rectum (30.8%) and prostate (30.8%). The median time interval between irradiation for the primary and SBRT reirradiation was 48 months (3–245). The typical reirradiation treatment was 35 Gy in five fractions, the median gross tumour volume size was 10.2 (0.3–110.5) ml and the most common target was the iliac nodes (40%). There were three (10%) acute grade 3 toxicities and no late grade 3 or more toxicities. At 12/24 months, local relapse-free survival, metastasis-free survival, progression-free survival and overall survival were 67.7%/50.7%, 67%/41.7%, 34.8%/14.9% and 83.2%/62.5%, respectively. On univariate analysis, improved local control was associated with low gross tumour volume (
ISSN:0936-6555
1433-2981
DOI:10.1016/j.clon.2020.06.009