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. 2021 Oct 30;16(1):208.
doi: 10.1186/s13014-021-01934-y.

Long-term cancer survivors treated with multiple courses of repeat radiation therapy

Sebastian M Christ  1 , Maiwand Ahmadsei  2 , Lotte Wilke  2 , Anja Kühnis  2 , Matea Pavic  2 , Stephanie Tanadini-Lang  2 , Matthias Guckenberger  2
Affiliations

Long-term cancer survivors treated with multiple courses of repeat radiation therapy

Sebastian M Christ et al. Radiat Oncol. .

Abstract

Introduction and background: Through recent advances in cancer care, the number of long-term survivors has continuously increased. As a result, repetitive use of local radiotherapy for curative or palliative indications might have increased as well. This analysis aims to describe patterns of care and outcome of patients treated with multiple courses of repeat radiotherapy.

Materials and methods: All patients treated with radiotherapy between 2011 and 2019 at our department of Radiation Oncology were included into this analysis. A course of radiotherapy was defined as all treatment sessions to one anatomical site under one medical indication. Demographics, cancer and treatment characteristics and overall survival of patients having undergone multiple radiotherapy courses (minimum n = 5) were evaluated.

Results: The proportion of cancer patients treated with a minimum five courses of radiotherapy increased continuously from 0.9% in 2011 to 6.5% in 2019. In the 112 patients treated with a minimum of five radiotherapy courses, the primary tumor was lung in 41.9% (n = 47), malignant melanoma in 8.9% (n = 10) and breast in 8.0% (n = 9) of cases. A median interval of 3 years (maximum 8 years) elapsed between the first and the last radiotherapy course. The maximum number of courses in a single patient were n = 10. Treatment intent was curative or palliative in 46.4% and 53.6% for the first radiotherapy, respectively. The proportion of curative intent decreased to 11.6% at the 5th, and the last radiotherapy course was following a palliative intent in all patients. Five-year overall survival measured from the 1st radiotherapy course was 32.7%. Median overall survival was 3.3, 2.4, 1.3, and 0.6 years when measured from the 1st, the 1st palliative, the 5th and last course of radiotherapy, respectively.

Discussion and conclusion: A continuously increasing number of patients is treated with multiple courses of radiotherapy throughout their long-term cancer survivorship.

Keywords: Multiple courses; Radiation therapy; Repeat irradiation.

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Conflict of interest statement

MG received research support from Varian, ViewRay and AstraZeneca. STL received a research grant from Varian, honoraria from Varian and her husband is employed at Varian.

Figures

Fig. 1
Fig. 1
Overall distribution of the number of radiotherapy courses per patient. RT radiation therapy
Fig. 2
Fig. 2
Overall survival from time of a 1st RT treatment course, b 1st curative RT course. RT radiation therapy
Fig. 3
Fig. 3
Comparison of overall survival from a 1st RT for patients with 5 RT versus > 5 RT courses, (p value = 0.07), b date of primary diagnosis for patients with 5 RT versus > 5 RT courses, (p value = 0.48). RT radiation therapy
Fig. 4
Fig. 4
Treatment intent over the course of multiple RT treatment courses. RT radiation therapy. *Patients may be counted more than once. **The non-linear trend between palliative and curative intent is due to the “dynamic oligometastatic state model”
Fig. 5
Fig. 5
Treatment time between different RT courses at our department. RT radiation therapy. 1Median time between courses is calculated based on all patients having received up to the nth course
See this image and copyright information in PMC

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