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Ronan Valentine



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    P1.16 - Treatment of Early Stage/Localized Disease (Not CME Accredited Session) (ID 948)

    • 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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      P1.16-26 - Safety of SABR (Stereotactic Ablative Body Radiotherapy) for Central Non-Small Cell Lung Cancers (cNSCLC) with 50 Gray in 5 Fractions (50Gy/5f) (ID 12732)

      16:45 - 18:00  |  Author(s): Ronan Valentine

      • Abstract
      • Slides

      Background

      SABR using 60Gy/3f (or equivalent) caused high toxicity when used for cNSCLC. To determine a safe SABR dose for cNSCLC, the phase I/II RTOG 0813 trial used 50Gy/5f as a baseline. From 2013, 50Gy/5f was adopted for inoperable early-stage cNSCLC at the West of Scotland Cancer Centre, a tertiary-level oncology unit. We report our prospectively collected toxicity and efficacy data.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      Patients with cNSCLC were identified from the radiotherapy database. cNSCLC was defined as lung cancers within 2cm of the proximal bronchial tree, or the planning target volume (PTV) abutting the mediastinal pleura/pericardium. Patient and treatment characteristics were obtained from electronic medical records. All patients received 50Gy/5f on alternate days with a volumetric arc therapy plan using TrueBeam linear accelerators. Toxicity was assessed in a centralised follow-up clinic 2 weeks, 6 weeks, 3 months, 6 months, 1 and 2 years after treatment using Common Toxicity Criteria Adverse Events version 3. Patients had a CT scan at 3 months post-treatment. Subsequent CT scans were at the discretion of the treating clinician.

      4c3880bb027f159e801041b1021e88e8 Result

      50 patients (31 females, 19 males, median age 75.1 years old) were identified with T1-2N0M0 cNSCLC. 84% were medically unfit for surgery. 40% had biopsy-proven NSCLC. All patients completed treatment on schedule. Two patients died within 90 days of treatment, one from a chest infection, the other cause of death was unknown. Table 1 describes the early and late toxicity. Over a median follow-up of 24 months, there were 20 deaths, 8 unrelated to cancer, and 12 due to cancer recurrence. The median progression free survival and overall survival are 26.0 months (95% confidence interval: 16.4, 35.6 months) and 28.6 months (95% confidence interval: 21.3, 35.8 months) respectively.

      world lung abstract table 1.jpg

      8eea62084ca7e541d918e823422bd82e Conclusion

      This study has demonstrated that 50Gy/5f is a safe dose and fractionation for early-stage inoperable cNSCLC, with outcomes comparable to other series.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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