Kevin Jang: Stereotactic reirradiation for in-field lung cancer recurrence after stereotactic ablative radiotherapy
Kevin Jang, Radiation Oncology Advanced Trainee at Royal North Shore Hospital, shared a post on X about a paper he co-authored with colleagues published in Radiotherapy and Oncology:
Authors: Kevin Jang, Shamira Cross, Roland Yeghiaian-Alvandi.
“Pleased to share our latest work in Radiotherapy and Oncology.
In-field lung re-SABR achieves excellent outcomes with low toxicities.
Size, dose, timing matters. Best results seen in recurrent tumours <2cm, cumulative BED ≥200 Gy, and interval >12 months.
Can you safely re-SABR lung cancers that recur in-field after SABR?
In-field LR occur in 10-15% and salvage options are limited.
- Surgery: often inoperable
- Ablation: high risk
- Systemic therapy: limited local control
Could repeat SABR offer a curative path?
We conducted the first meta-analysis on this cohort across 12 studies involving 197 patients
- Pooled 1-yr LC: 78.2%
- Pooled 2-yr LC: 68.0%
- Median OS: 26.3 mo
- ≥G3 tox: <3%
So what predicts better outcomes?
- Tumor size <2 cm
- Cumulative BED ≥200 Gy
- Interval >12 months between SABR courses
Size. Dose. Timing. All critically influence local control.
What about toxicity?
- Pneumonitis ≥ Grade 2: 6.4%
- Grade 3 events: rare
- Grade 4–5 toxicity: only in central tumors
- Peripheral lesions had excellent safety profiles.
Key takeaway: location matters for reirradiation safety.”
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