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Ugur Selek
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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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P1.17-02 - Low Prognostic Nutritional Index Predicts Poor Survival in Stage IIIB Non-Small Cell Lung Cancer Patients Treated with Chemoradiotherapy (ID 14133)
16:45 - 18:00 | Author(s): Ugur Selek
- Abstract
Background
The prognostic role of prognostic nutritional index (PNI) has been widely investigated and showed in many types of cancer. However, to our best knowledge, the significance of PNI has never been investigated in locally advanced non-small cell lung cancer (NSCLC) who were treated with concurrent chemoradiotherapy ( CCRT). Therefore in this current study, we aimed to investigate the prognostic impact of PNI on survival outcomes of locally advanced NSCLC undergoing CCRT.
a9ded1e5ce5d75814730bb4caaf49419 Method
The data of 358 patients with stage IIIB NSCLC treated with CCRT were analyzed retrospectively. All patients received 60 to 66 Gy (2 Gy per fraction) thoracic radiotherapy and at least one course of platinum-based doublet chemotherapy concomitantly. For each patient PNI was calculated by the known formula in blood samples those were available prior to CCRT: [PNI=10×serum albumin (g/dl) + 0.005×total lymphocyte count (mm3)]. The primary endpoint was the association between PNI and overall survival (OS). Secondary endpoints were locoregional progression-free survival (LPFS) and progression-free survival (PFS). The survival curves were calculated by Kaplan-Meier method and log-rank test. The cutoff value of the PNI was analyzed by receiver operating curve (ROC).
4c3880bb027f159e801041b1021e88e8 Result
At a median follow-up of 22.5 months (2.4-123.5 months) 108 patients (30.2%) were still alive. For the whole study cohort median OS was 25.2 months (95 % CI: 22.7-27.7). The median LPFS and PFS were 15.4 months (95% CI: 14.4-16.4) and 10.7 months (95% CI: 9.7-11.7) respectively. In ROC analysis, calculated cutoff value of PNI was 40.1 (AUC: 67.8% (62.0-73.6); sensitivity: 73.1; specificity: 68.4, p<0.001). According to this, patients were grouped as follows, group 1: PNI>40 and group 2: PNI<40. Accordingly, for the patients in group 1, OS (36.7 vs. 16.8 months, p<0.001), LPFS (19.5 vs. 11.5 months, p<0.001) and PFS (13.6 vs. 8.6 months, p<0.001) times were significantly better as compared to patients in group 2. Results of the multivariate analysis demonstrated that the prognostic worth of PNI was independent of the other covariates (p<0.001, for each survival endpoints).
8eea62084ca7e541d918e823422bd82e Conclusion
Being the first of its kind study the result of this current investigation revealed that the PNI which is easy to calculate, easily achievable with no additional cost has a strong prognostic value in prognostic stratification of the stage IIIB NSCLC patients undergoing to CCRT.
6f8b794f3246b0c1e1780bb4d4d5dc53
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P2.16 - Treatment of Early Stage/Localized Disease (Not CME Accredited Session) (ID 965)
- 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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P2.16-14 - Results of Stereotactic Radiation Therapy (SABR) in Early Stage Lung Cancer: Turkish Radiation Oncology Group (TROG) Study (ID 12612)
16:45 - 18:00 | Author(s): Ugur Selek
- Abstract
Background
To determine factors affecting treatment outcomes for SABR in inoperable early stage lung cancer (ESLC) patients treated by TROG member centers.
a9ded1e5ce5d75814730bb4caaf49419 Method
A total of 386 ESLC patients treated with SABR between 2009-2017 were retrospectively analyzed. Factors related to disease, treatment and patients’ characteristics were recorded. Primary endpoints were overall survival (OS), progression free survival (PFS), local control (LC), regional control (RC) and radiation-related toxicities.
4c3880bb027f159e801041b1021e88e8 Result
Median follow-up was 21 months. Median SABR dose was 54Gy (30-70Gy), corresponding to a biological equivalent dose (BED) of 112Gy (48-180Gy) administered in median 5 fractions. Patient and treatment characteristics are in Table 1. Response evaluation was made in median 3 months after SABR and complete response; partial response, stable disease and progression rates were 48%, 36%, 5.7% and 0.5%, respectively. One and 3 years LC and RC rates were 97%, 91% and 93%, 86%, respectively.
8eea62084ca7e541d918e823422bd82e Conclusion
On multivariate analyzes BED10<90 Gy (HR 3.6;1.3-9.9), SCC histology (HR 2.2;1.2-4) and less than complete response (HR 3.5; 1.6-7.5) were predictive of worse LC. Tumor size >3cm was the only predictor of low RC (HR 2.1; 1.1-4.2).
One and 3 years PFS and OS were 88%, 72% and 90%, 65%, respectively.
T2 tumor (HR 2.5; 1.5-3.6), BED10<90Gy (HR 2.1; 1.1-4) and SCC (HR 1.4; 1.0-1.8) had lower PFS. OS was negatively affected by tumor size >28mm (HR1.6; 1.0-2.5)
No severe acute side effects were observed. Overall 18 patients experienced =grade 3 pneumonitis, 11 chest wall pain and 1 rib fracture.
Results of this retrospective study have shown that SABR is an encouraging technique with satisfactory LC and OS rates and minimal toxicity in patients with inoperable ESLC. Higher dose and intensification of treatment in patient with large tumors, SCC histology and less than complete response may result in better LC, PFS and OS.
6f8b794f3246b0c1e1780bb4d4d5dc53
