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D. Stobo



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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
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      P1.05-035 - SABR for Medically Inoperable Early Stage NSCLC at the Beatson West of Scotland Cancer Centre: Outcomes and Toxicity (ID 4798)

      14:30 - 15:45  |  Author(s): D. Stobo

      • Abstract

      Background:
      SABR is now an established therapeutic option for patients with medically inoperable early stage NSCLC. It is well tolerated and associated with low rates of Grade 3+ toxicity. Here we present the outcomes and toxicity data for the SABR service based at the Beatson West of Scotland Cancer Centre (BWoSCC).

      Methods:
      All 102 consecutive patients (median age 72 (range 47-91) years, 60 (59%) female) who received SABR between October 2011 and May 2014 at the BWoSCC were identified from a prospectively maintained electronic database. Toxicity data was collected at pre-determined intervals in a dedicated follow-up clinic. Radiological evidence of pneumonitis was scored on follow-up CT imaging at 3 months post-SABR. Outcomes were collated from electronic records.

      Results:
      Median and minimum follow-up were 37.1 and 24.1 months respectively. Histological confirmation of NSCLC was available for 33 (32.4%) patients. Local and regional control rates at 2 years were 95.1% and 94.1% respectively. 8.8% of patients developed metastases within 2 years with a median time to detection of metastases of 6.9 months. Overall survival (OS) at 1, 2, 3 and 4 years post-SABR was 88.2% (95%CI 80.2-93.1%), 75.5% (65.9-82.7%), 59.8% (48.2-69.7%) and 51.4% (38.8-62.7%) respectively. No difference in OS was apparent between histologically confirmed and unconfirmed subgroups (p=1.0). On multi-variable analysis, tumour size >= 20mm was negatively associated with OS (p=0.003) whilst gender, age, performance status, deprivation index and histological confirmation were not associated. Radiological scoring of post-SABR pneumonitis was available for 69 patients. A total of 33 of these patients (48%) had radiological evidence of pneumonitis. No association between V5 or V20 and radiological pneumonitis was identified. One death occurred that was potentially related to radiation pneumonitis. Otherwise, only 1 patient experienced grade 4 toxicity (fatigue) and 5 patients (4.9%) reported grade 3 toxicity (4x dyspnoea, 1x fatigue) within 12 months of SABR. There were 4 instances of rib fracture with no association with maximum chest wall dose.

      Conclusion:
      Within the Beatson West of Scotland Cancer Centre the use of SABR for early stage NSCLC is associated with high rates of loco-regional control. Our overall survival and toxicity data compare favourably with published series.