Salvage lung SBRT may be a curative option after lobectomy.

Background: This study intends to analyze the feasibility and the outcomes of stereotactic body radiotherapy (SBRT) as a salvage treatment for lung cancer after primary surgery and compare them with the results of SBRT as the first treatment option.

Materials and methods: Retrospective analysis of early-stage non-small cell lung cancer (NSCLC) treated with SBRT, either as a primary treatment or as salvage treatment after primary surgery.

Results: From January 2017 to January 2022, 68 patients were analyzed. 80% were 65 years-old or above. Seven (10%) underwent SBRT as a salvage treatment after primary surgery. Most lesions treated with primary SBRT were peripheral (n = 33; 54.1%), opposed to the salvage group, where 71.4% were central lesions (n = 5). Patients who had previous surgery presented with lower forced expiratory volume in 1 second (FEV1) (p = 0.006). Median time between surgery and salvage SBRT was 35.4 months. Median follow-up was 29.3 months; median overall survival (OS) at 2 years and 3 years was, respectively, 73.5% and 67.6% (median 52.5 months), with no difference between groups. Median local, regional, and distant progression free survivals were not reached. Local control was 94.1% at 2 years and 92.6% at 3 years. Only 5 (8.2%) patients presented late grade 3-4 pneumonitis, and one, grade 5 (fatal), all in the primary SBRT group.

Conclusion: SBRT as salvage after primary surgery is feasible and seems to be safe. Outcomes are expected to be equivalent to those of the patients submitted to primary SBRT.