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Hui Liu
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P1.14 - Radiotherapy (ID 700)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Radiotherapy
- Presentations: 3
- Moderators:
- Coordinates: 10/16/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P1.14-010 - SGA Could Be a Predictive Factor for Radiation Pneumonitis in Lung Cancer Patients Treated by Concurrent Chemoradiotherapy (ID 8080)
09:30 - 16:00 | Presenting Author(s): Hui Liu
- Abstract
Background:
To investigate the relationship between malnutrition and the severity of radiation pneumonitis (RP) in lung cancer patients with normal baseline pulmonary function and lungs’ V20<35% treated by intensity-modulated radiation therapy (IMRT) and concurrent chemotherapy.
Method:
One hundred and fifty patients with lung caner who received definitive IMRT (≥60 Gy) and concurrent chemotherapy were enrolled. In the condition of normal baseline pulmonary function and strict constraints of the irradiation dose to normal lung tissues, we recorded Eastern Cooperative Oncology Group (ECOG) score, concurrent chemotherapy, clinical stage, the level of albumin (ALB), hemoglobin and C-reactive protein (CRP), Subjective Global Assessment (SGA) scores and radiation esophagitis (RE) grade. These factors were correlated with RP using univariate and multivariate regression analyses.
Result:
Of 150 patients, 12 patients (8.0%) developed Grade 3–5 RP, 37 (24.6%) patients developed Grade 3–5 esophageal toxicity. In univariate analysis, ALB level (p = 0.002), RE (p < 0.001) and SGA score (p < 0.001) were significantly associated with RP. Multivariate analysis revealed that SGA (p < 0.001) was the independent predictor of RP.
Conclusion:
SGA could be a predictor for RP in lung cancer patients treated with definitive IMRT and concurrent chemotherapy.
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P1.14-011 - An Esophagus-Sparing Technique to Limit Radiation Esophagitis in Locally Advanced NSCLC Treated by SIB-IMRT and Concurrent Chemotherapy (ID 8090)
09:30 - 16:00 | Presenting Author(s): Hui Liu
- Abstract
Background:
To investigate the incidence of radiation esophagitis (RE) and tumor local control using esophagus sparing technique in locally advanced non-small cell lung cancer (LANSCLC) treated by simultaneous integrated boost intensity-modulated radiation therapy (SIB-IMRT) and concurrent chemotherapy.
Method:
Ninety-five patients with stage IIIA/B NSCLC who received definitive SIB-IMRT and concurrent chemotherapy had been divided into two groups: 1.with esophagus sparing technique; 2.without esophagus sparing technique. Chi-square test was performed to compare sex, clinical stage, histology, concurrent chemotherapy, RE and nutrition status between two groups. T-test was used to compare the dosimetric parameters. Overall survival (OS) and loco-regional failure free survival (LRFS) were calculated by the Kaplan–Meier method and compared by a log-rank test.
Result:
There were 50 patients in the esophagus sparing group and 45 in the non-sparing group. The incidence of severe RE (Grade 3-5) was significantly lower in patients with esophagus sparing technique (p = 0.000). Patients in esophagus sparing group had better nutrition status (p = 0.029). With a median follow-up of 23 months (range 0-37 months), the 3-year OS of all the patients was 33.4%. OS time was found to be longer in the esophagus-sparing group (32 vs. 27 months, p= 0.010). LRFS was comparable between two groups (29 vs. 24 months, p=0.960).
Conclusion:
Esophagus-sparing technique is an effective and essential method to limit RE in LANSCLC treated by SIB-IMRT and concurrent chemotherapy. Reducing severe RE when escalating radiation fraction size may help to achieve higher local control and better general performance status.
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P1.14-012 - Hypofractionated Simultaneous Integrated Boost IMRT Concurrent with Chemotherapy Improved Loco-Regional Control in Locally Advanced NSCLC (ID 8242)
09:30 - 16:00 | Presenting Author(s): Hui Liu
- Abstract
Background:
This study investigated the loco-regional control (LRC) and toxicity of hypofractionated simultaneous integrated boost intensity-modulated radiotherapy (SIB-IMRT) for locally advanced non-small-cell lung cancer (LANSCLC) in the setting of concurrent chemotherapy.
Method:
One hundred and ten LANSCLC patients treated with SIB-IMRT and concurrent chemotherapy were retrospectively analyzed. Radical-intent radiotherapy was delivered at a fraction dose of 2.0~2.2, 2.4~2.6, and 2.9~3.1Gy respectively. Factors potentially predictive of LRC (age, sex, tumor stage, tumor volume, biological effective dose (BED), dose per fraction, overall radiation time (ORT) and concurrent chemotherapy) were assessed in the univariate analysis and Cox multivariate model. Toxicity data was collected and analyzed.
Result:
With a median follow-up of 24.4 months, the median duration of LRC was 21.4 months. LRC was 71.9% at 1 year, 45.9% at 2 years, and 41.8% at 3 years. In univariate analysis, BED (p=0.007), dose per fraction (p=0.002) and ORT (p=0.029) were associated significantly with LRC. In multivariate analysis, RT dose per fraction was independently prognostic of LRC (HR, 0.597; CI, 0.362~0.986). Grade ≥3 pneumonitis, pulmonary fibrosis and esophagitis were observed in 6 (5.5%), 2 (1.8%) and 19 (17.3%) of patients, respectively. There was no significant difference in toxicity among different doses per fraction.
Conclusion:
Our study showed that LRC was improved by the dose per fraction escalation in the setting of concurrent chemotherapy. Hypofractionated SIB-IMRT could be a feasible and effective approach for dose intensification, while maintaining tolerable toxicities.
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P2.14 - Radiotherapy (ID 715)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Radiotherapy
- Presentations: 1
- Moderators:
- Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P2.14-004 - Comparable Local Controls after Twice-Daily and Once-Daily Chest Radiotherapy in Extensive Stage Small Cell Lung Cancer (ID 8788)
09:30 - 16:00 | Author(s): Hui Liu
- Abstract
Background:
The optimal radiation schedule for small cell lung cancer (SCLC) has not yet fully established. This study was designed to compare the clinical outcomes between twice- and once-daily radiotherapy in the treatment of SCLC.
Method:
One hundred and twenty-four consecutive patients diagnosed with extensive stage SCLC and treated with chemoradiotherapy were retrospectively reviewed. Either twice-daily hyper-fractionated irradiation (45 Gy/30 fractions/BID), or alternative schedules, including hypo-fractionated (45 Gy/15 fractions/QD) or conventionally fractionated (50 Gy/25 fractions/QD or 60 Gy/30 fractions/QD) radiation was delivered, with etoposide and platinum prescribed concurrently or sequentially. Local controls and overall survivals were calculated and compared between twice- and once-daily schedules based on Kaplan-Meier method. Toxicities were record according to Common Terminology Criteria Adverse Events.
Result:
There were 67 and 57 patients received twice- and once-daily chest radiotherapy, respectively. With a median follow-up of 27 and 24 months, the local control rates were reported 64.2% and 63.2%. The 2-year estimated local progression-free survival rates were similar (61.6% vs 61.0%, p=0.90). Progressive disease identified three months after radiotherapy was correlated to increased local failure (p=0.026). There was no difference between the incidences of grade 3-4 toxicities between twice- and once-daily schedules (23.9% vs 12.3%, p=0.16).
Conclusion:
Either twice- (45 Gy/30 fractions/BID) or once-daily (45 Gy/15 fractions/QD, 50 Gy/25 fractions/QD, 60 Gy/30 fractions/QD) radiation schedule could be considered in the treatment of SCLC, resulting in comparable local control and toxicities.
