Multimodality Imaging Based Treatment Volume Definition for Reirradiation of Recurrent Small Cell Lung Cancer (SCLC)

Abstract

Objective: Small cell lung cancer (SCLC) may be considered as a major health concern as a leading cause of cancer related mortality worldwide. Despite intensive management, SCLC may follow an aggressive disease course with recurrent and/ or metastatic disease in a considerable proportion of the patients. Herein, we assess multimodality imaging based treatment volume definition for reirradiation of recurrent SCLC. Literature Review: Definition of treatment volume by multimodality imaging with incorporation of positron emission tomography (PET) or by computed tomography (CT)-simulation images only has been evaluated with comparative analysis for patients reirradiated for recurrent SCLC. Results: A multidisciplinary team of experts from surgery, medical oncology, radiation oncology, and pulmonology has been involved in individualized patient evaluation. Decision making for reirradiation of patients with recurrent SCLC has been performed after comprehensive assessment considering the lesion size, localization and association with critical structures, previously administered treatments at initial diagnosis, and time interval from initial RT. Treatment volume determination by CT-only imaging and by CT-PET fusion based imaging has been assessed with comparative analysis. Ground truth target volume has been found to be identical with treatment volume determination by CT-PET fusion based imaging as the primary result of this study. Conclusion: Incorporation of PET in RT planning process may be considered for patients receiving reirradiation for recurrent SCLC. Clearly, further investigation is required to shed light on this issue.