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Meltem Dagdelen



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    P3.08 - Oligometastatic NSCLC (Not CME Accredited Session) (ID 974)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall
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      P3.08-11 - Differences in Evaluations of Early Thorax CT’s Post Lung Stereotactic Body Radiotherapy (SBRT) (ID 14086)

      12:00 - 13:30  |  Author(s): Meltem Dagdelen

      • Abstract
      • Slides

      Background

      Radiological changes after lung SBRT reflect variety and diversity compared to the changes after irradiation with other radiotherapy techniques. This leads to confusion in evaluating treatment response and changes in lungs,especially for the physicians who are not aware of the radiological changes after SBRT.Our study has aimed to compare evaluations of clinicians with various expertise on post SBRT early Thorax CT images in patients with early stage lung cancer or pulmonary metastasis.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      Posttreatment CT scans from 19 patients and 20 lesions treated with lung SBRT during 2015-2017 were reviewed retrospectively.Thorax CT within 3 months after SBRT were evaluated individually by 8 physicians from radiology,radiation oncology,nuclear medicine and chest disease.Two physicians were chosen from each departments.One senior and one junior 2 physicians were assessed the CT images.The physicians were blinded to the original CT reports and they assesed CT scans independently.These evaluations were compared with evaluation of the radiation oncologist who was experienced in thoracic radiology and applied SBRT.Four choices were provided to physicians who were asked to choose one(0:Stable,1: Regression,2:Progression,3:Reactive changes due to SBRT).CT images were reviewed through ExtremePacs® Pacs Software version 4.3 programme.Coherence coefficients of the evaluations were calculated by the Cohen-kappa test.

      4c3880bb027f159e801041b1021e88e8 Result

      SBRT was applied to 6 patients with stage 1 lung cancer,10 with stage 4 lung cancer and 3 pulmonary metastasis.One patient received SBRT for 2 nodules in different lobes in the ipsilateral lung.The median SBRT dose was 55 Gy(32-60)/3-10 fractions and biological effective dose (BED10) was 115,5Gy(48 -180).When we took into account all CT scans during the whole follow-up period,all lesions had complete or partial response.When the evaluations of the physicians were compared with the reference radiation oncologist,the strongest coherence coefficient was found with the senior radiation oncologist(ĸ: 0,72).The Kappa coefficients between the junior radiation oncologist,junior nuclear medicine physicians and the reference physician were 0.61, 0.55 respectively.The compliances were lower for the other physicians(ĸ:0,48,ĸ:0,48,ĸ:0,45,ĸ:0,37). It was observed that such non-conformity was caused by misinterpretation of RT changes and mostly confused with progression.

      8eea62084ca7e541d918e823422bd82e Conclusion

      Early radiological changes after lung SBRT can be observed in different forms and misinterpreted by physicians from different specializations and the acute changes are confused with progression,mostly.Although our study was conducted with a small number of patients,findings support this argument.Therefore,radiation oncologists who apply SBRT have to be aware of these radiological changes and evaluate accurately by themselves.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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