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M. Chen



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    P1.07 - Poster Session/ Small Cell Lung Cancer (ID 221)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Small Cell Lung Cancer
    • Presentations: 1
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      P1.07-010 - Hyperfractionated Versus Hypofractionated Radiotherapy for Limited-Stage SCLC: A Retrospective Comparison of Two Prospective Studies (ID 592)

      09:30 - 17:00  |  Author(s): M. Chen

      • Abstract
      • Slides

      Background:
      The optimal thoracic radiation dose/fraction for limited-stage small cell lung cancer (SCLC) is not yet established at present. This study mainly aims to retrospectively compare the impact on local/regional control of different thoracic radiation dose/fraction schedules from two prospective trials.

      Methods:
      Patients received thoracic radiotherapy consisted of 1.5 Gy twice a day in 30 fractions over a 19-day period to a total of 45 Gy (hyperfractionated arm, BED=53.3 Gy) or 2.5 Gy daily in 22 fractions over a 30-day period to a total of 55 Gy (hypofractionated arm, BED=62.6 Gy) combined with concurrent chemotherapy were included into this study. A statistical software package SPSS 13.0 was applied, and Kaplan-Meier method was used to estimate survival data. Fisher’s exact test was used for comparisons of categorical data.

      Results:
      From 2005 to 2014, nighty-two patients were accrued into to the hyperfractionated arm. From 2005 to 2012, nighty-one patients were accrued into the hypofractionated arm. The 1-year, 2-year local/regional progression free survival rates of hyperfractionated arm and hypofractionated arm were 82.1%, 60.7% and 83.8%, 67.9%, respectively (P=0.33). The median survival time (months) of hyperfractionated arm and hypofractionated arm were 27.9 (95% CI: 15.7-40.1) and 22.0 (95% CI: 16.4-27.5) respectively, while 1-year, 3-year, 5-year overall survival rates of the two arms were 85.2%, 39.4%, 26% and 77.1%, 34.4%, 26.9% respectively (P=0.48). Grade 2 and 3 acute radiation esophagitis were observed in 28.3%, 8.7% and 15.5%, 2.1% of patients in hyperfractionated arm and hypofractionated arm (P=0.009). Figure 1 Figure 2





      Conclusion:
      This study indicated that the use of hypofractionated radiotherapy failed to significantly improve the local regional control rate and overall survival time compared with hyperfractionated radiotherapy. However, the incidence of grade 2 and 3 acute radiation induced esophagitis was significantly more common in the hyperfractionated arm than in hypofractionated arm.

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    P2.03 - Poster Session/ Treatment of Locoregional Disease – NSCLC (ID 213)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Treatment of Locoregional Disease – NSCLC
    • Presentations: 1
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      P2.03-038 - Whole Tumor Perfusion CT in Patients with NSCLC Treated with Endostar Combined with Concurrent Radiotherapy (ID 997)

      09:30 - 17:00  |  Author(s): M. Chen

      • Abstract
      • Slides

      Background:
      Endostar was reported as an anti-angiogenic agent, which could inhibit new vessel formation in tumor. This study is to investigate the NSCLC response to Endostar combined with concurrent radiotherapy using volumetric perfusion CT.

      Methods:
      This study was performed with the approval of the local Medical Ethics Committee, and all the enrolled patients gave their written informed consent before the inclusion in the study. Six patients with NSCLC were involved in the current study. The histological subtype for each patient was confirmed by biopsy. All patients were treated with Endostar combined with concurrent radiotherapy for 7 weeks. Whole tumor perfusion CT was performed for all patients before treatment (baseline) and 4weeks after combined therapy on a dual-source CT. All images were reviewed in consensus by 2 radiologists. Blood flow (BF), blood volume (BV) and permeability (PMB) values for the whole tumor were calculated by an alternative deconvolution algorithm and then quantitatively assessed. These perfusion parameters before and after therapy were compared to investigate the therapy response of NSCLC.

      Results:
      Histology revealed adenocarcinoma (AC) in 3 patients and squamous cell carcinoma (SCC) in 3 patients. In SCC group, BF, BV and PMB at baseline were 116.2±34.57, 11.53±3.14 and 21.87±4.86. Four weeks after treatment, those perfusion values were 50.59±16.09, 4.58±1.26 and 10.70±1.05 respectively, which showed obvious decreasing trends compared with baseline data. In AC group, BF, BV and PMB at baseline were 66.58±5.82, 6.66±0.14 and 16.50±1.29, respectively. The parameters were 49.94±5.07, 5.45±1.34 and 13.2±1.67 respectively, which did not show obvious changes compared with baseline data. However, the tendency of perfusion parameters might vary considerably. Of 3 patients with AC, 1 case also showed decreasing trend of BF, BV and PMB after treatment compared with baseline data. On the basis of RECIST criteria, all the four cases (3 cases with SCC and 1 case with AC) that perfusion parameters showed obvious decreasing trend were classified as having a partial response (PR) to therapy, the remaining 2 cases with AC as having stable disease.

      Conclusion:
      The AC and SCC might respond differently to treatment with endostar combined with concurrent radiotherapy. The obvious decreasing trend of perfusion parameters after therapy might predict a better response to endostar combined with concurrent radiotherapy.

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