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P. Paredes



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    Poster Display session (Friday) (ID 65)

    • Event: ELCC 2018
    • Type: Poster Display session
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 4/13/2018, 12:30 - 13:00, Hall 1
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      122P - Pathological response rates after induction radio-chemotherapy in stage III NSCLC (ID 229)

      12:30 - 13:00  |  Author(s): P. Paredes

      • Abstract

      Background:
      This retrospective analysis was designed to assess pathological tumor response to radical (60 Gy) radio-chemotherapy (RTx/CTx) and surgery in stage III NSCLC (TNM 8th edition).

      Methods:
      We included patients treated from a phase II trial and a few patients with salvage surgery after multidisciplinary decision by Lung Committee (05/2012–10/2017). Induction CTX (CDDP/Carbo doublets) was with concurrent RTx (59–62 Gy). Pathologic N2 were by mediastinoscopy (Md) or endobronchial ultrasound (EBUS). CT scans were performed within 3–4 weeks of treatment. Pathologic examination of residual viable tumor was take in account pT and pN, downstaging and pCR.

      Results:
      Median age: 59 years (range 41–77). Gender: 65.5% was male. Stage: 58.6% IIIA, 37.9% IIIB, 1 3.4% IV (brain metastases treated with radiosurgery). TNM: 27.6% T2b, 24.1% T3, 20.7% T4, 10.3% T2b, 10.3% T1c and 6.9% T1b, 6.9%; N0 86.2% N2,6.9% N3; 3.4% M1b (Brain). Histological: Adenocar 62.1%, 34.5% squamous, 3.4% NSCLC. N2-N3: 62.1% by EBUS, 3.4% by Md, 20.7% needed both. Nodal station distribution: 37.9% 1- N1 and 1-N2; 31% 1-N2, 13.8% 2-N2 and 1-N1, 6,9% 1-N1, 1-N2 and 1-N3, 3,4% 2-N2 and 6,9% N0. CTx: CDDP + Vp16 - 58.75% and CDDP + VNR 27.6%, Toxicites CTx/RTx: Anemia G3 (13.8%), G4 (3.4%); leucopenia, G3 (20.7%), G4 (17.2%); neutropenia, G3 (24.1%), G4 (10.3%). Esophagitis G2 (31%); 27,6% were hospitalised by toxicities. Radiological response: 1 (3.4%) progression, 12 (41.4%) stable, 16 (55.2%) partial response. Surgery: 86.2%; 58.6% lobectomy (LB), 3.4% biLB, 3.4% pneumectomy, 3.4% LB + bronchoplasty, 10.3% LB + ribs resection, 6.9% LB + ribs+ hemivertebral resection. Downstaging: 69%. pCR: 20.7%; Histological tumor viability (Tv): 24.1% pCR, 20.7% a 5% Tv, 17.2% between 10–15% Tv, 13.7% between 20 and 30% Tv, 6.8% between 40 and 50% Tv, 3.4% with 90% Tv; Histological lymph node Nv: 72.4% pCR, 6.8% between 5 and 10% Nv, 6.8% between 40 and 100% Nv.

      Conclusions:
      RTx/CTx and surgery in stage III NSCLC presents high rates of downstaging with a high percentage of toxicities that required an experienced multidisciplinary team able to anticipate and treat these conditions. We consider the different pathological responses must be correlated with an adequate and long follow-up that led us to analyze possible recurrence patterns with an impact on the management, survival and quality of life of these patients.

      Clinical trial identification:


      Legal entity responsible for the study:
      Clinic

      Funding:
      Has not received any funding

      Disclosure:
      All authors have declared no conflicts of interest.