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P1.01 - Advanced NSCLC (ID 757)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Advanced NSCLC
- Presentations: 1
- Coordinates: 10/16/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
P1.01-078b - Dose-Paiting Radiation with Concurrent Chemotherapy for Locally Advanced Non-Small Cell Lung Cancer (ID 10093)
09:30 - 16:00 | Presenting Author(s): Junchao Wang
Although outcomes for early stage lung cancer are encouraging,overall survival with standard therapy is only 15-30% for nearly half of all patients with Stage III disease. The local recurrence is the main failure mode. We retrospectively analyzed the treatment of dose-painting radiotherapy with chemotherapy for the locally advanced non-small cell lung cancer.
Eligible patients had to have biopsy confirmed non-small cell lung cancer (NSCLC) and had stage III, T1-4N2-3M0 and T3N1M0 disease. All the patients received two 21-day cycles of cisplatin plus paclitaxel. The dose-painting target was defined using 18F-fluorodeoxyglucose (FDG) positron emission tomography in 47 patients with the non-small cell lung cancer. Doses of 70-80 Gy(3.5-4 Gy/fraction) and 60 Gy (3Gy/fraction) were prescribed to the PET-based planning target volume (PTVPET) and the union of PET and anatomical imaging-based PTV, respectively, in 20 fractions, using simultaneous integrated boost. After concurrent chemoradiotherapy, patients received an additional two cycles of consolidation chemotherapy.
Median follow-up time from the end of treatment was 62.1 months (range 37.6–111.5 months). All 47 patients completed treatment without interruptions and no incidents of early grade 4+ toxicity were observed. The incidence of Grade ≥2 radiation pneumonitis was 14.9% ,the incidence of Grade ≥ 3 esophagitis was 4.26%.the 1,3,5-year OS were 63.8% ,25.5%,12.1%. the 1,3,5 year disease-free survival rate were 48.9%,14.9%,8.5%. The1,3,5-year local-control rates were 64.7%, 32.6%,13%. Late radioactive esophagitis were seen in only 2 patients who experienced Swallowing obstruction. Only 1 patient was observed who has severe symptom of pulmonary fibrosis. Fatal bronchopulmonary hemorrhage did not occur.
Dose-paiting radiation with concurrent chemotherapy is feasible and well tolerated. Local-control rates are encouraging.But further large-scale randomized controlled studies are needed to confirm it.