Stereotactic Body Radiation Therapy (SBRT) for the Treatment of Primary Lung Cancer in Recipients of Lung Transplant

Abstract

Background: Lung transplantation is a life-saving treatment for patients with end stage lung disease. There may be a higher incidence of lung cancer in lung transplant recipients, and these cancers tend to be diagnosed in a more advanced stage. There is very little data on the safety and efficacy of Stereotactic Body Radiation Therapy (SBRT) for lesions in the native lung in lung-transplant recipients.

Materials and Methods: A retrospective chart review of all patients who have undergone lung transplantation and treated with SBRT for lung cancer in the native lung in the Davidoff Cancer Center.

Results: Four patients who were treated with SBRT to a total of 5 lesions were included. Two patients were treated without histological confirmation of malignancy. All cases were discussed in a multidisciplinary team before being referred for radiotherapy. Standard SBRT dosing was used. Responses were achieved by imaging in all cases – 3 lesions exhibited a complete response and two lesions partial responses. The patients who had partial responses developed distant metastases and died shortly. No patient developed measurable toxicity.

Conclusions: SBRT is effective and safe for the management of lung cancer in lung-transplanted patients. Standard dose and fractionation can be used.