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J. Lilley
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P1.05 - Poster Session with Presenters Present (ID 457)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Early Stage NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)
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P1.05-030 - Lung SABR for Early Stage Lung Cancer: Outcomes and Toxicity of 803 Patients Treated at the Leeds Cancer Centre (ID 5874)
14:30 - 15:45 | Author(s): J. Lilley
- Abstract
Background:
SABR is an established treatment for early peripheral stage non-small cell lung cancer (NSCLC) in medically inoperable patients We present the outcomes 803 patients, a large prospective series of patients, with a minimum 12 months follow-up after undergoing SABR treatment in Leeds, UK, between May 2009 and May 2015.
Methods:
Patients with a pathological or clinical diagnosis of peripheral stage I lung cancer, and deemed medically inoperable, were treated with SABR at the Leeds Cancer Centre, using a dose fractionation of 54Gy/3#, 55Gy/5#, or 60Gy/8# depending on proximity of organs at risk. Patient follow-up was assessed using an electronic patient record and radiology reports. Survival analysis was performed using Kaplein-Meier estimation and log rank test was used to compare survival distibutions including performance status, histology, tumour T stage, tumour location, post-SABR fibrosis, and toxicity.
Results:
803 patients were treated with SABR and had at least 12 months follow-up. Mean age at treatment was 73.9 years (39 to 94 years). Median follow-up was 23.3 Months, from time of last treatment fraction to last medical contact or death. Median overall survival estimate was 33.3 Months (95% C.I. 29.54-27.1 Months) 1 year OS – 80.1% (SE 1.4%), 3 year OS – 46.4% (SE 2%), 5 year OS – 29.5% (SE 2.6%) Local control (LC) 1 year LC – 99.2% (SE 0.3%), 2 year LC – 97.2% (SE 0.7%), 3 year LC – 95.1% (SE 0.9%) Both performance status and tumour size were associated with a worse overall survival, Log rank p<0.001 (PS), p=0.035 (T stage). Toxicity Only 4 patients had documented grade 3 toxicity. 3 pneumonitis requiring admission, and 1 patient developed a bronchopulmonary fistula 2 years post-treatment. 44 Patients had a rib fracture recorded, of these 16 patients were symptomatic, and were treated with analgesia or neuropathic adjuncts. 156 patients had documented radiological pneumonitis (gd 1), with 331 developing fibrotic change in the treatment area. Of interest the presence of radiological pneumonitis and fibrotic changes was associated with an improved overall survival, Log rank P=0.009 (Rad pneum), P<0.001 (Fibrosis).
Conclusion:
SABR for early stage lung cancer is a safe and effective treatment even in medically inoperable patients, with excellent local control. In our cohort, we found radiological pneumonitis and fibrosis was associated with an improved overall survival, which may be indicative of the patient response to SABR, and will need further evaluation. Performance status and tumour size were associated with a poorer overall survival.
