Prognostic analysis of helical tomotherapy stereotactic body radiotherapy in multiple primary or second primary lung cancers

Abstract Purpose To evaluate the safety and efficacy of Helical Tomotherapy stereotactic body radiotherapy (HT-SBRT) in treating multiple primary lung cancers (MPLCs) and second primary lung cancer (SPLC). Methods From January 2010 to September 2023, 106 MPLCs and SPLC (T1-3N0M0) underwent HT-SBRT....

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Main Authors: Jintao Ma, Xiaohong Xu, Wenhan Huang, Yong Hu, Gang Chen, Jian He
Format: Article
Language:English
Published: BMC 2025-01-01
Series:BMC Cancer
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Online Access:https://doi.org/10.1186/s12885-025-13540-2
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Summary:Abstract Purpose To evaluate the safety and efficacy of Helical Tomotherapy stereotactic body radiotherapy (HT-SBRT) in treating multiple primary lung cancers (MPLCs) and second primary lung cancer (SPLC). Methods From January 2010 to September 2023, 106 MPLCs and SPLC (T1-3N0M0) underwent HT-SBRT. The cumulative incidence for local recurrence (LR) was calculated using the competing risk approach and compared using Gray’s test. Cancer-specific survival (CSS) and progression-free survival (PFS) were assessed using Kaplan-Meier analysis and log-rank tests. Results After adjusting for competing risks, the LR rates for all lesions (n = 150) was 15.3%, with 2- and 4-year rates of 7.5% and 11.4%. For second primary lung nodules post-surgery, the cumulative incidence of LR was 16.1%, with 2- and 4-year rates of 6.9% and 8.7%. In MPLCs treated with HT-SBRT, the cumulative incidence of LR was 14.3%, with 2- and 4-year rates of 8.2% and 14.3%. In patients with MPLCs treated with HT-SBRT (n = 27), the CSS rates at 2, 4, and 10 years were 90.5%, 78.6%, and 53.6%, respectively, and the PFS rates were 59.5%, 32.8%, and 24.6%. In patients with SPLC who received HT-SBRT after surgery (n = 79), the CSS rates at 2, 4, and 10 years were 90.9%, 81.7%, and 61.0%, respectively, while the PFS rates were 75.4%, 64.4%, and 58.5%. Additionally, 0.9% of patients experienced grade 3 acute radiation pneumonitis, and no severe (grade 4–5) toxicities were reported. Conclusions HT-SBRT may be a safe and effective treatment for MPLCs and SPLC, though prospective studies are needed to confirm its efficacy.
ISSN:1471-2407