From 2017 - 2020, 42
patients were treated with CK for lung lesion (20 primary lung & 22 lung
oligometastasis). In 20 primary lung cancer patients (12 Adenocarcinoma, 6 SCC,
1 neuroendocrine,1 no biopsy) 14 male patients, mean age 70 yrs (38-90 yrs), 13
had co-morbidities, peripheral lesions 15, central lesions 5, right lung 15,
left lung 5, 9 (45%) had stage I and 5 (25%) stage II. Six (30%) patients with
primary lung cancer and metastasis underwent RT for both metastatic and primary
site. Stage IA1, IA2, IA3, IB, IIA, IIB were 1 (5%), 3 (15%), 3 (15%), 2 (10%),
2 (10%), 3 (15%) respectively. Three (15%) were treated with 22-26Gy/1fr, 7
(35%) with 42-45Gy/3fr, 8 (40%) with 40-50Gy/5fr, 1 (5%) each with 36Gy/4fr and
48Gy/8fr. PTV mean volume 38.1 cc (8.3-88.3cc). Mean OS & PFS 14 (2-43 mo)
& 8 mo (3-37 mo) respectively. At last follow up (F/U), 15 patients were
alive, 3 were dead and 2 lost to F/U. In stage I and stage II disease local
failure rate was 2/9 (22%) and 1/5 (20%). In primary lung with metastatic
disease treated with local RT, 3/6 (50%) had local failure. Nine patients had
disease progression (6 local, 3 distant). In 22 patients with 23 lung
oligometastasis, 3 had synchronous and 19 had metachronous lung metastasis.
Primary site colo-rectal in 9, thyroid in 3, kidney 4, head neck in 2, liver in
1, endometrium in 1, pancreas in 1, sarcoma 1. Mean age 60 yrs (36-83 yrs), 12
male patients, 7 had comorbidities. Five patients had DFI ≤ 1yr, 5 patients 1-2 yr, and 9 patients more than 2 yr. Mean PTV was 21cc
(range: 2.8 – 78 cc). 18–24 Gy/1fr, 45-54Gy/3fr, 35-50Gy/1fr & 48Gy/8fr in 6,
8, 5 and 1 patient respectively. 17 patients were evaluable for ‘response to
CK’ evaluation [local response 88% (15/17) with CR 76% (13/17) & PR 12% (2/17)].
2 (12%) papillary carcinoma thyroid patients had progressive disease. At mean
F/U of 11 mo, 7 (32%) were alive with controlled disease, 8 (36%) were alive
with disease progression. 2 (9%) had local and distant failure and 10 (45%) had
systemic progression. Mean OS & PFS 11 mo (2-26mo) and 8.5 mo (2-26mo). Median
OS for synchronous oligometastasis 22 mo. At post-CK 3 mo, 1 patient required intercostal
drainage and pleurodesis. Radiological complete response after CK in metastasis
and primary lung cancer was 15/22 (68%) and 9/20 (45%) respectively. PTV volume
(<10cc; p=0.011) and BED (>110 Gy; p=0.009) were significant factors
influencing complete response to treatment. Histology (adenocarcinoma Vs SCC;
p=0.416) was not significant.