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F.M.N.H. Schramel

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    P1.03 - Poster Session/ Treatment of Locoregional Disease – NSCLC (ID 212)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Treatment of Locoregional Disease – NSCLC
    • Presentations: 1
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      P1.03-023 - Changes in Pulmonary Function after Stereotactic Body Radiotherapy and after Surgery for Stage I and II Non-Small-Cell Lung Cancer (ID 2596)

      09:30 - 17:00  |  Author(s): F.M.N.H. Schramel

      • Abstract
      • Slides

      Although surgical resection is the standard treatment for stage I and II non-small-cell lung cancer (NSCLC), approximately 20% of these patients are not eligible for surgery. Stereotactic body radiotherapy (SBRT) is a good alternative treatment for these patients. Lung resection will lead to a decrease in pulmonary function. However, previous studies have shown that pulmonary function after SBRT remains either stable or shows a small decline post-SBRT. In this study changes in pulmonary function tests (PFTs) were evaluated at different follow-up durations, up to more than 2 years after treatment in both groups.

      All patients diagnosed with stage I and II NSCLC and treated with SBRT or surgery between 2008 and 2011 at St. Antonius Hospital Nieuwegein, The Netherlands were included. There was no routine protocol for assessment of post-treatment PFTs. Therefore, follow-up durations were categorized in early (0-9 months), middle (10-21 months) and late (≥ 22 months). We assessed forced expiratory volume in 1 second (FEV1) and diffusion capacity to carbon monoxide corrected for the actual hemoglobin level (DLCOc) absolute and percentage of predicted values. Wilcoxon signed-rank test for paired samples was used to analyze statistical differences between baseline- and follow-up PFTs.

      Among 230 patients, 123 patients had both pre- and a minimum of one post-treatment PFT. Of the 123 patients, 30 patients were treated with SBRT and 93 patients with surgery. Mean pre-treatment FEV~1~ and DLCOc values were respectively 1.27 liter (54.90% of predicted) and 4.25 mL/min/mmHg (56.11% of predicted) in the SBRT group and 2.44 liter (88.38% of predicted) and 6.10 mL/min/mmHg (71.96% of predicted) in the surgery group. There were significant changes in FEV~1 ~and DLCOc after surgery for all follow-up durations. After SBRT, absolute FEV~1 ~values remained stable up to 22 months. After 22 months a statistical significant change was observed (from 1.27 liter pre-treatment to 1.11 liter (p=0.008). DLCOc was not significantly impaired after SBRT (from 4.25 mL/min/mmHg pre-treatment to 3.47 mL/min/mmHg (p=0.061)), and showed a small, non-significant, increase for the middle-follow-up term (to 5.22 mL/min/mmHg) compared to pre-treatment values.

      Surgery results in a decline of pulmonary function short after resection and on long-term, for stage I and II non-small-cell lungcancer. Pulmonary function after SBRT showed a non-significant decline, except for absolute FEV~1~ values at long-term follow-up. Further analysis of these data must reveal if these changes are clinically significant.

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