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Matthew Hatton



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    MA05 - Improving Outcomes in Locoregional NSCLC II (ID 901)

    • Event: WCLC 2018
    • Type: Mini Oral Abstract Session
    • Track: Treatment of Locoregional Disease - NSCLC
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/24/2018, 13:30 - 15:00, Room 105
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      MA05.12 - Discussant - MA 05.09, MA 05.10, MA 05.11 (ID 14592)

      14:45 - 15:00  |  Presenting Author(s): Matthew Hatton

      • Abstract
      • Presentation
      • Slides

      Abstract not provided

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    P1.17 - Treatment of Locoregional Disease - NSCLC (Not CME Accredited Session) (ID 949)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall
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      P1.17-05 - Accelerated Radiotherapy for Non-Small Cell Lung Cancer: A 12 Year Retrospective Review of Two Dose Fractionation Schedules (ID 13818)

      16:45 - 18:00  |  Presenting Author(s): Matthew Hatton

      • Abstract
      • Slides

      Background

      Numerous dose fractionation regimes have been used for inoperable NSCLC patients and there is evidence that accelerated schedules can produce better outcome than conventionally fractionated treatment (1). Continuous hyperfractionated accelerated radiotherapy (CHART, 54Gy in 36 fractions over 12 days) and accelerated hypofractionated radiotherapy (55Gy in 20 fractions over 4 weeks) have been routinely used in Sheffield over the past decade, with schedule selection largely down to patient choice (in-patient vs out-patient treatment). In this single-centre retrospective analysis, we present the outcomes for all patients treated with these two schedules between 2003 to 2015.

      Ref

      1. LePechoux C, Mauguen A, Baumann M, et al. Hyperfractionated or Accelerated Radiotherapy in Lung Cancer: An Individual Patient Data Meta-Analysis. JCO 2012;30:2788-2797.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      In this audit details on patient demographics, tumour characteristics and survival data was collected from the electronic hospital records and supplemented by information from patient notes. Dosimetric data for tumour and organs at risk were collated automatically via the Varian Eclipse Scripting application programming interface. Descriptive statistical analysis was performed using the SSPS package with clinical and dosimetric variables assessed using independent samples t-tests and survival via a log-rank test. Multivariate survival analysis was performed using Cox regression.

      4c3880bb027f159e801041b1021e88e8 Result

      We identified 883 eligible patients, of which 45% received CHART and 55% hypofractionated radiotherapy. Mean age was 70 years and 58% were male. PET staging was performed in 87% with 30%, 15%, 51% and 4% being stage I, II, III and IV, respectively. 63% had a WHO performance status of 0-1. 38% of patients underwent induction chemotherapy. 99% completed their prescribed radiotherapy treatment with an overall response rate of 60%. Relapse was observed in 50% of patients with median disease-free survival of 19.4 months. 2-year overall survival was 47% with a median overall survival of 23.2 months. Multivariate analysis identified histology, stage, performance status, use of chemotherapy as independent predictors of survival. No significant differences between the two radiotherapy regimes was seen for any parameters.

      8eea62084ca7e541d918e823422bd82e Conclusion

      This audit has confirmed that both CHART and hypofractionated accelerated radiotherapy are deliverable and well tolerated schedules when used in day to day practice. We have detected no significant difference in outcome between the two schedules and there is the need to explore avenues, eg dose escalation, that develop these schedules to match outcomes reported by recent concurrent chemo-radiation studies.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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    P2.01 - Advanced NSCLC (Not CME Accredited Session) (ID 950)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/25/2018, 16:45 - 18:00, Exhibit Hall
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      P2.01-43 - ADSCaN: A Randomised Phase II Study of Accelerated, Dose Escalated, Sequential Chemo-Radiotherapy in Non-Small Cell Lung Cancer (NSCLC) (ID 13934)

      16:45 - 18:00  |  Presenting Author(s): Matthew Hatton

      • Abstract
      • Slides

      Background

      Lung cancer is the most common cause of cancer mortality in the UK, and NSCLC accounts for approximately 85% of all lung cancers. Most patients present with inoperable disease therefore radiotherapy plays a major role in treatment. However, the majority of patients are not suitable for gold standard treatment (concurrent chemo-radiotherapy) due to performance status and comorbidities. Novel strategies integrating radiotherapy advances and radiobiological knowledge need to be evaluated in patients treated with sequential chemo-radiotherapy. Four separate accelerated dose escalated radiotherapy schedules have been completed in UK (CHART-ED{1}, IDEAL-CRT{2}, I-START{3} and Isotoxic IMRT{4}). ADSCaN will compare these schedules with a UK standard sequential chemo-radiotherapy schedule. A combined randomized phase II screening / ‘pick the winner’ approach will identify the best schedule to take into a randomised phase III study against conventionally fractionated radiotherapy.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      Suitable patients will have histologically / cytologically confirmed, stage III NSCLC and be able to undergo chemo-radiotherapy treatment. The study will recruit 360 patients; 130 on the standard arm and 60 on each experimental arm. Patients will complete 2-4 cycles of platinum based chemotherapy before being randomised to one of the radiotherapy schedules.

      Logistic / capacity challenges make it impractical for sites to open all experimental trial arms; a novel trial design allows centres to select upfront the experimental arms they are able to participate in and all will offer the standard arm.

      adscan_trial_schema_v5_17jan2017.jpg

      4c3880bb027f159e801041b1021e88e8 Result

      CURRENT STATUS

      CRUK is funding this multicentre study which is being co-ordinated by the CRUK CTU Glasgow. The study opened to recruitment on 22/08/2017 with planned recruitment lasting 3 years 8 months. The study includes a tailored QA programme through the UK RTTQA Group. 20 of the 36 sites expressing interest have started the QA process, 12 have completed with a further 8 expected to complete in the next few months.

      8eea62084ca7e541d918e823422bd82e Conclusion

      Section Not Applicable

      6f8b794f3246b0c1e1780bb4d4d5dc53

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