Author of

• 25953

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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

  • 27270

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    P2.16-15 - Toxicities and Survival after Stereotactic Ablative Radiotherapy (SABR) for Centrally Located Lung Tumors (ID 13736)

    16:45 - 18:00  |  Author(s): Gorkem Gungor
    • Abstract
    • Slides

    Background
    

    To evaluate factors associated with local control (LC), overall survival (OS) and toxicities after SABR to centrally located primary non-small cell lung (PL) and oligometastatic (OM) tumors.

    a9ded1e5ce5d75814730bb4caaf49419 Method
    

    Seventy centrally located tumors ( abutting tracheobronchial tree [TBT], <2cm from TBT, or intersecting mediastinum) in 65 patients treated with linear accelerator-based SABR between 2009 and 2016 were retrospectively studied. Impact of patient, tumor, and treatment parameters on LC, OS and toxicity-free survival (TFS) were evaluated by multivariate analyses.

    4c3880bb027f159e801041b1021e88e8 Result
    

    Forty-eight PL and 22 OM lesions were analyzed, including 20 (28%) re-irradiation (Re-RT) cases. Median total, fractionated, and biological equivalent doses in BED10 and BED3 were 55 (30-60), 9.75 (4-18), 110 (41-151), and 228 (90-378) Gy, respectively. Doses given as Re-RT were lower (median Re-RT BED10 dose 94 vs. 110 Gy, P=0.009). Complete response (CR) was obtained in 43 (61%) lesions. None of the analyzed factors correlated to CR. After a median follow-up of 57 (48-65, 95%CI) months, 10 (14%) lesions had relapsed and 37 (57%) patients had died (2 and 5-year LC and OS rates were 84/70% and 52/28%, respectively). In univariate analysis, 2-year LC was lower for lesions with no CR and for colorectal cancer lesions. Only “no CR” was significant (100 vs. 51%; HR=18.2, CI 2.3-146, P=0.006) in final multivariate analyses. Median OS was significantly lower in patients with grade 3+ toxicity (5 months after grade 3+ toxicity, vs. 39 months in others [HR 4.7, CI 2-11.2,P<0.0001]). OS was marginally lower in patients with primary lung cancer compared to patients with OM tumors (19 vs. 49 months, HR 2.3, CI 1-5.6, P=0.06). Among 17 toxicities, 5 reached grade 5. For patients with grade 3+ toxicities, TFS was lower after Re-RT (2-year TFS 63% vs. 96%, HR 5.1, CI 1.3-20.3, P=0.022) but did not differ significantly for lesions abutting TBT (2-year TFS 69% vs. 93.4%, HR 3.5, CI 0.9-13.9, P=0.08).

    8eea62084ca7e541d918e823422bd82e Conclusion
    

    SABR is an effective treatment modality in centrally located lung tumors. SABR to re-irradiated lesions and possibly lesions abutting TBT may have the higher risks for serious toxicities. Further studies are indicated.

    6f8b794f3246b0c1e1780bb4d4d5dc53

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