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G.G. Hanna
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P2.05 - Poster Session with Presenters Present (ID 463)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Radiotherapy
- Presentations: 1
- Moderators:
- Coordinates: 12/06/2016, 14:30 - 15:45, Hall B (Poster Area)
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P2.05-020 - Survival Outcomes in Stage 1 NSCLC Following Stereotactic Ablative Radiotherapy or Conventional Radiotherapy (ID 6164)
14:30 - 15:45 | Author(s): G.G. Hanna
- Abstract
Background:
Stereotactic ablative radiotherapy (SABR) is a radiotherapy technique using ultra-hypofractionated treatment to deliver a high biological dose to early stage lung cancers. It is believed that SABR is more effective than conventional fractionated external beam radiotherapy (EBRT), however definitive evidence of superior survival outcomes from controlled trial comparisons is lacking. Across the UK access to SABR is not been uniform, with only certain centres delivering the technique. Before the introduction of a routine lung SABR service in 2013, patients from Northern Ireland were referred to English Centres to have SABR. We compare the outcomes of those patients who had SABR to those who had conventional fractionated radiotherapy for early stage lung cancer.
Methods:
Using our institutional electronic database, which includes all patients who had radiotherapy in the treatment of lung cancer, we identified those patients who had received SABR or who were eligible to receive it based on UK consortium guidelines (tumor size <= 4cm, tumor > 2cm from main airways, performance status 0-3). The time period of 2009 to 2015 inclusive was chosen as SABR treatment was funded from this time point onwards. Patient baseline demographics, lung function, tumor size, the reason for the treatment received, details of the treatment received (e.g. dose, use of respiratory compensation, IGRT and Type B planning algorithm) and survival outcomes were recorded for each patient.
Results:
Between 2009 and 2015, eighty patients received SABR and an additional 63 were eligible to have SABR but received conventional EBRT (62 patients received 55Gy in 20 fractions and 1 patient received 66Gy in 33 fractions). The main reason for eligible patients not receiving SABR was that the patient did not want to travel or was not fit to travel to another country to have treatment with SABR (43% of all non-SABR patients). The 2-year overall survival for those receiving SABR was 68% versus 43% for those receiving conventional radiotherapy (HR 2.3 (95% CI 1.4 – 3.8), p=0.0007). Both disease free survival and metastasis free survival rates were superior in the SABR group. On univariate analysis of the various patient and treatment factors, only tumor size remained significant between the groups.
Conclusion:
In this cohort of patients there is evidence of improved local control, disease free survival and overall survival for SABR compared to conventional fractionated radiotherapy. SABR should be available in all radiotherapy centres for the treatment of early stage lung cancer.
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P3.06 - Poster Session with Presenters Present (ID 492)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Trial Design/Statistics
- Presentations: 1
- Moderators:
- Coordinates: 12/07/2016, 14:30 - 15:45, Hall B (Poster Area)
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P3.06-003 - SARON: Stereotactic Ablative Radiotherapy for Oligometastatic Non-Small Cell Lung Cancer (NSCLC). A UK Randomised Phase III Trial (ID 3814)
14:30 - 15:45 | Author(s): G.G. Hanna
- Abstract
Background:
It has been theorised that local ablative therapy such as stereotactic ablative radiotherapy (SABR) and stereotactic radiosurgery (SRS) could improve outcomes for patients with oligometastatic disease. There is now growing evidence to support the safety, local control effect and potential improvement in overall survival (OS) for SABR/SRS to warrant a randomised phase III trial. The SARON trial investigates the impact on OS of radiotherapy (RT) plus SABR/SRS following standard chemotherapy in patients with oligometastatic NSCLC and will undertake an early evaluation of feasibility and toxicity.
Methods:
SARON is a randomised, multicentre, phase III trial for patients with oligometastatic NSCLC (1-3 sites of synchronous metastatic disease). An early feasibility review will take place after 50 randomised patients. Patients requiring both conventional thoracic RT to the primary and SABR to a thoracic metastasis will be included in a sub-study to more thoroughly assess toxicity and planning issues. 340 patients will be recruited from 30 UK sites, to randomise 306 patients (1:1) to receive either platinum doublet chemotherapy alone (control arm) or platinum doublet chemotherapy followed by radical RT/SABR to their primary tumour and then SABR and/or SRS to all other metastatic sites (investigational arm). Figure 1
Results:
The primary endpoint is OS, and the study is powered to detect an improvement in median survival from 9.9 months in the control arm to 14.3 months in the investigational arm (85% power, 5% two-sided alpha). The secondary endpoints include progression free survival, toxicity, local control of primary and metastases, and quality of life.
Conclusion:
The study will open in Q3 2016 and is supported by Cancer Research UK (C13530/A18015).
