Efficacy and safety analysis in metastatic cancer patients treated with multiple courses of repeat radiation therapy
Background and purpose: Due to advances in oncology, a growing proportion of patients is treated with repetitive courses of radiotherapy. The aim of this study is to analyze whether radiotherapy maintains its safety and efficacy profile in patients treated with multiple repeat courses of irradiation...
| Główni autorzy: | , , , , , , , , |
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| Format: | Artykuł |
| Język: | English |
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Elsevier
2023-11-01
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| Seria: | Clinical and Translational Radiation Oncology |
| Hasła przedmiotowe: | |
| Dostęp online: | http://www.sciencedirect.com/science/article/pii/S240563082300112X |
| _version_ | 1827776226440249344 |
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| author | Maiwand Ahmadsei Sebastian M. Christ Tiuri E. Kroese Anja Kühnis Jonas Willmann Panagiotis Balermpas Nicolaus Andratschke Stephanie Tanadini-Lang Matthias Guckenberger |
| author_facet | Maiwand Ahmadsei Sebastian M. Christ Tiuri E. Kroese Anja Kühnis Jonas Willmann Panagiotis Balermpas Nicolaus Andratschke Stephanie Tanadini-Lang Matthias Guckenberger |
| author_sort | Maiwand Ahmadsei |
| collection | DOAJ |
| description | Background and purpose: Due to advances in oncology, a growing proportion of patients is treated with repetitive courses of radiotherapy. The aim of this study is to analyze whether radiotherapy maintains its safety and efficacy profile in patients treated with multiple repeat courses of irradiation. Material and methods: All patients treated between 2011 and 2019 at our institution were screened for a minimum of five repeat irradiation courses, to analyze treatment characteristics, survival, safety and efficacy. The type of re-irradiation was classified according to ESTRO-EORTC consensus guidelines. Results: A total of n = 112 patients receiving n = 660 radiotherapy courses were included in this retrospective cohort study. The most frequent primary tumors were lung cancer in 41.9 % (n = 47) and malignant melanoma in 8.9 % (n = 10). The most frequent re-irradiation types were repeat irradiation and Type 2 re-irradiation in 309 (46.8 %) and 113 (17.1 %) cases, respectively. Median survival after the first course of radiotherapy was 3.6 (0.3–13.4) years. Response to radiotherapy was observed in 548 (83.0 %) cases and CTCAE toxicity grade ≥ 3 was observed in 21 (3.2 %) cases. An increasing number of RT courses (HR: 1.30, p=<0.0001), Type 1 re-irradiation (HR 3.50, p = 0.008) and KPS ≤ 80 % (HR: 2.02, p = 0.002) were associated with significantly worse treatment responses. Toxicity rates remained stable with increasing numbers of RT courses. Conclusion: Multiple courses of repeat radiotherapy maintain a favorable therapeutic ratio of high response combined with reasonable safety profile. |
| first_indexed | 2024-03-11T14:02:08Z |
| format | Article |
| id | doaj.art-6ea6b9238c7b417ab9b788c4f2ca7a4c |
| institution | Directory Open Access Journal |
| issn | 2405-6308 |
| language | English |
| last_indexed | 2024-03-11T14:02:08Z |
| publishDate | 2023-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Clinical and Translational Radiation Oncology |
| spelling | doaj.art-6ea6b9238c7b417ab9b788c4f2ca7a4c2023-11-02T04:13:40ZengElsevierClinical and Translational Radiation Oncology2405-63082023-11-0143100687Efficacy and safety analysis in metastatic cancer patients treated with multiple courses of repeat radiation therapyMaiwand Ahmadsei0Sebastian M. Christ1Tiuri E. Kroese2Anja Kühnis3Jonas Willmann4Panagiotis Balermpas5Nicolaus Andratschke6Stephanie Tanadini-Lang7Matthias Guckenberger8Department of Radiation Oncology and Competence Center for Palliative Care, University Hospital and University of Zurich, Zurich, Switzerland; Corresponding author at: Department of Radiation Oncology, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland.Department of Radiation Oncology and Competence Center for Palliative Care, University Hospital and University of Zurich, Zurich, SwitzerlandDepartment of Radiation Oncology and Competence Center for Palliative Care, University Hospital and University of Zurich, Zurich, SwitzerlandDepartment of Radiation Oncology and Competence Center for Palliative Care, University Hospital and University of Zurich, Zurich, SwitzerlandDepartment of Radiation Oncology and Competence Center for Palliative Care, University Hospital and University of Zurich, Zurich, Switzerland; Center for Proton Therapy, Paul Scherrer Institute, ETH Domain, Villigen, SwitzerlandDepartment of Radiation Oncology and Competence Center for Palliative Care, University Hospital and University of Zurich, Zurich, SwitzerlandDepartment of Radiation Oncology and Competence Center for Palliative Care, University Hospital and University of Zurich, Zurich, SwitzerlandDepartment of Radiation Oncology and Competence Center for Palliative Care, University Hospital and University of Zurich, Zurich, SwitzerlandDepartment of Radiation Oncology and Competence Center for Palliative Care, University Hospital and University of Zurich, Zurich, SwitzerlandBackground and purpose: Due to advances in oncology, a growing proportion of patients is treated with repetitive courses of radiotherapy. The aim of this study is to analyze whether radiotherapy maintains its safety and efficacy profile in patients treated with multiple repeat courses of irradiation. Material and methods: All patients treated between 2011 and 2019 at our institution were screened for a minimum of five repeat irradiation courses, to analyze treatment characteristics, survival, safety and efficacy. The type of re-irradiation was classified according to ESTRO-EORTC consensus guidelines. Results: A total of n = 112 patients receiving n = 660 radiotherapy courses were included in this retrospective cohort study. The most frequent primary tumors were lung cancer in 41.9 % (n = 47) and malignant melanoma in 8.9 % (n = 10). The most frequent re-irradiation types were repeat irradiation and Type 2 re-irradiation in 309 (46.8 %) and 113 (17.1 %) cases, respectively. Median survival after the first course of radiotherapy was 3.6 (0.3–13.4) years. Response to radiotherapy was observed in 548 (83.0 %) cases and CTCAE toxicity grade ≥ 3 was observed in 21 (3.2 %) cases. An increasing number of RT courses (HR: 1.30, p=<0.0001), Type 1 re-irradiation (HR 3.50, p = 0.008) and KPS ≤ 80 % (HR: 2.02, p = 0.002) were associated with significantly worse treatment responses. Toxicity rates remained stable with increasing numbers of RT courses. Conclusion: Multiple courses of repeat radiotherapy maintain a favorable therapeutic ratio of high response combined with reasonable safety profile.http://www.sciencedirect.com/science/article/pii/S240563082300112XRadiation therapyRe-irradiationRepeat radiotherapyToxicityLocal control |
| spellingShingle | Maiwand Ahmadsei Sebastian M. Christ Tiuri E. Kroese Anja Kühnis Jonas Willmann Panagiotis Balermpas Nicolaus Andratschke Stephanie Tanadini-Lang Matthias Guckenberger Efficacy and safety analysis in metastatic cancer patients treated with multiple courses of repeat radiation therapy Clinical and Translational Radiation Oncology Radiation therapy Re-irradiation Repeat radiotherapy Toxicity Local control |
| title | Efficacy and safety analysis in metastatic cancer patients treated with multiple courses of repeat radiation therapy |
| title_full | Efficacy and safety analysis in metastatic cancer patients treated with multiple courses of repeat radiation therapy |
| title_fullStr | Efficacy and safety analysis in metastatic cancer patients treated with multiple courses of repeat radiation therapy |
| title_full_unstemmed | Efficacy and safety analysis in metastatic cancer patients treated with multiple courses of repeat radiation therapy |
| title_short | Efficacy and safety analysis in metastatic cancer patients treated with multiple courses of repeat radiation therapy |
| title_sort | efficacy and safety analysis in metastatic cancer patients treated with multiple courses of repeat radiation therapy |
| topic | Radiation therapy Re-irradiation Repeat radiotherapy Toxicity Local control |
| url | http://www.sciencedirect.com/science/article/pii/S240563082300112X |
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