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Sung-Ja Ahn

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    P1.12 - Small Cell Lung Cancer/NET (Not CME Accredited Session) (ID 944)

    • 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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      P1.12-07 - Time to the End of Thoracic Radiotherapy Affects to Survival Outcomes Greater than Radiation Dose in Limited Stage Small Cell Lung Cancer (ID 13607)

      16:45 - 18:00  |  Presenting Author(s): Sung-Ja Ahn

      • Abstract
      • Slides


      Early thoracic radiotherapy (TRT) concurrent with chemotherapy and radiation doses of 45 Gy given 1.5 Gy bid still has taken a seat as a standard treatment option for limited-stage small cell lung cancer (LS-SCLC). We aim to search the association between radiation parameters and survival outcomes in LS-SCLC patients who undertaken more than 45 Gy of TRT.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      One hundred and one patients with LS-SCLC who completed TRT between August 2005 and March 2014 were reviewed retrospectively. Median age was 64 years (43-80) and male to female was 88 vs. 13. Stage IIIA was 30 and IIIB was 55, respectively. TRT was performed using 3-dimensional conformal radiation therapy (3DCRT) and delivered using 2Gy single fraction per day in 73.2% of patients. The median dose TRT was 50 Gy (45-65), and all patients received concurrent chemoradiotherapy. PCI was combined in 56 (55.4%) patients.

      4c3880bb027f159e801041b1021e88e8 Result

      The median survival for all patients was 26.9 months. Local failure occurred in 41 patients (40.5%), and distant metastasis was noted in 54 patients (53.4%). The 3-year local control, progression-free survival (PFS), and overall survival (OS) rates were 52.0%, 29.5%, and 56.4%, respectively. On univariate analysis, the American Joint Committee on Cancer stage (p<0.001), timing of TRT (≤2 vs, >2 cycles, p=0.017), tumor response (CR vs. PR, p=0.015), the duration from the start date of chemotherapy to the end of TRT (SER) (≤70 vs >70 days, p=0.025), and PCI (p=0.003) were the significant predictors of OS and stage (p<0.001) and PCI (p=0.017) were the significant predictors in PFS. Multivariate analysis revealed that stage (hazard ratio [HR], 3.61; 95% CI, 2.15-6.07) was the only significant factor in PFS and stage (HR, 2.49; 95% CI, 1.56-3.98), SER (HR, 1.93; 95% CI, 1.22-3.07), PCI (HR, 0.52; 95% CI, 0.33-0.84), and tumor response (HR, 1.76; 95% CI, 1.12 – 2.77) were the significant predictors in OS. There was one fatal radiation pneumonitis. Grade 3 radiation pneumonitis and esophagitis was shown in 7 (6.9%) vs. 7 (6.9%) patients, respectively. Grade 3 and 4 leukopenia was shown in 30 (29.7%) vs. 11 (10.8%) patients and febrile neutropenia was 9 (8.9%) vs. 1 (0.9%) patients, respectively.

      8eea62084ca7e541d918e823422bd82e Conclusion

      SER less than 70 days was a significant predictors of OS in LS-SCLC patients who received more than 45 Gy of TRT concurrently with chemotherapy. We could not find any significant positive survival benefits of TRT dose or BED escalation in our patients groups.


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