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Case Series
Radiation pneumonitis after repeat stereotactic body radiation therapy for early-stage non-small cell lung cancer: A case series of two patients
1 MD, Department of Radiology, National Hospital Organization Nagasaki Medical Center, 2-1001-1 Kubara, Omura, Nagasaki 856-0835, Japan
2 Professor, Department of Clinical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
3 MD, Department of Radiology, Sasebo City General Hospital, Hirase 9-3, Sasebo, Nagasaki 857-8511, Japan
Address correspondence to:
Kazuto Ashizawa
Department of Clinical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501,
Japan
Message to Corresponding Author
Article ID: 100109Z10YT2022
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Tasaki Y, Ashizawa K, Nakamura D, Mizowaki T. Radiation pneumonitis after repeat stereotactic body radiation therapy for early-stage non-small cell lung cancer: A case series of two patients. J Case Rep Images Oncology 2022;8(2):10–14.ABSTRACT
Introduction: Stereotactic body radiation therapy (SBRT) is a well-established treatment option for patients with early-stage non-small cell lung cancer (NSCLC). We retrospectively identified 82 patients with early-stage NSCLC treated with SBRT at our institution between November 2009 and September 2019. Among these patients, two developed local recurrence or new primary lung cancer and lung metastasis or new primary lung cancer, respectively, and were treated with repeat SBRT. We herein report a case series of two patients with radiation pneumonitis after repeat SBRT.
Case Series: Case A was an 80-year-old woman diagnosed with stage I (T1aN0M0) squamous cell carcinoma. She received initial SBRT at an irradiation dose of 48 Gy in 4 fractions at the isocenter. Two years and three months after initial SBRT, the patient was clinically diagnosed with post-SBRT local recurrence or primary lung cancer and, thus, was treated with repeat SBRT at an irradiation dose of 60 Gy in 10 fractions. Six months later, the patient developed grade 5 radiation pneumonitis. Case B was an 89-year-old man diagnosed with stage I (T1cN0M0) adenocarcinoma. He received initial SBRT at an irradiation dose of 48 Gy in 4 fractions at the isocenter. Three years and six months after initial SBRT, the patient was clinically diagnosed with post-SBRT lung metastasis or primary lung cancer and, thus, was treated with repeat SBRT at an irradiation dose of 50 Gy in 4 fractions. Six months later, the patient developed grade 3 radiation pneumonitis.
Conclusion: Caution is needed when performing repeat SBRT.
Keywords: Non-small cell lung cancer, Radiation pneumonitis, Stereotactic body radiation therapy
SUPPORTING INFORMATION
Author Contributions
Yutaro Tasaki - Substantial contributions to conception and design, Acquisition of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Kazuto Ashizawa - Substantial contributions to conception and design, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Daisuke Nakamura - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Final approval of the version to be published
Takashi Mizowaki - Substantial contributions to conception and design, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2022 Yutaro Tasaki et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
