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Z. Hui



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    P1.08 - Locally Advanced NSCLC (ID 694)

    • Event: WCLC 2017
    • Type: Poster Session with Presenters Present
    • Track: Locally Advanced NSCLC
    • Presentations: 1
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      P1.08-007 - Surgery versus Concurrent Chemoradiotherapy for Resectable CIIIA-N2 NSCLC: A Propensity Score Matched Analysis (ID 8771)

      09:30 - 16:00  |  Author(s): Z. Hui

      • Abstract
      • Slides

      Background:
      Clinical ⅢA-N2 (cⅢA-N2) non-small cell lung cancer (NSCLC) is a heterogeneous group of diseases. Both surgery based multimodality treatment (S) and concurrent chemoradiotherapy (CCRT) can be applied. However, the optimal treatment modality remains controversial. This retrospective study aimed to compare the efficacy of two aforementioned treatment modalities in resectable cⅢA-N2 NSCLC.

      Method:
      From 2001 to 2010, 278 patients diagnosed with stage cⅢA-N2 NSCLC in our institution were enrolled, including 225 patients with surgery and 53 patients received CCRT. A propensity score matching (PSM) method (1:2) was utilized to obtain two matched groups: the S group and the CCRT group using the following variables: age, gender, smoking index, KPS, histology and T stage. The Kaplan-Meier method was used to calculate the overall survival (OS), progression-free survival (PFS), locoregional recurrence free survival (LRFS) and distant-metastasis free survival (DMFS), and the log-rank test was used to analyze differences between the groups.

      Result:
      There were 102 patients in the S group, including 65 patients (63.7%) treated with surgery followed by adjuvant chemotherapy and 37 patients (36.3%) treated with surgery followed by adjuvant chemotherapy and radiotherapy. Fifty-one patients received CCRT, including 29 patients (56.9%) treated with CCRT alone and 22 patients (43.1%) with consolidation chemotherapy. The median survival was 76.6 months in the S group, compared with 23.0 months in the CCRT group. The 1-, 3- and 5-year OS rates were 86.9%, 59.5% and 55.5% in the S group, which were statistically significantly higher than the rates of 59.2%, 36.7% and 31.5% in the CCRT group (p= 0.001). The 1-, 3- and 5-year DFS rates were 60.4%, 41.5% and 37.7% in the S group and 51.0%, 25.5% and 13.7% in the CCRT group, respectively (p= 0.002). The 5-year LRFS rate in the S group was 58.5% compared with 34.0% in the CCRT (p= 0.023). The 5-year DMFS rate was 55.7% in the S group versus 48.5% in the CCRT group (p= 0.674).

      Conclusion:
      In this retrospective study, surgery demonstrated significantly improved OS, DFS and LRFS compared with CCRT. Surgery based multimodality treatment may be preferred for patients with resectable cⅢA-N2 NSCLC.

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    P2.14 - Radiotherapy (ID 715)

    • Event: WCLC 2017
    • Type: Poster Session with Presenters Present
    • Track: Radiotherapy
    • Presentations: 1
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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): Z. Hui

      • 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.