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Gokhan Yaprak

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    Lunch & Poster Display session (ID 58)

    • Event: ELCC 2019
    • Type: Poster Display session
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 4/11/2019, 12:30 - 13:00, Hall 1
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      74P - Is there any prognostic significance of the level of change in SUVmax after SBRT in patients with early stage NSCLC? (ID 355)

      12:30 - 13:00  |  Presenting Author(s): Gokhan Yaprak

      • Abstract
      • Slides


      Stereotactic body radiotherapy (SBRT) is a standard treatment for early stage non-small cell lung cancer (esNSCLC) patients who are not eligible for surgery. We aimed to evaluate the prognostic significance of the level of change in SUVmax (ΔSUVmax) between pre and post-treatment PET/CT in esNSCLC patients treated with SBRT.

      a9ded1e5ce5d75814730bb4caaf49419 Methods

      Between November 2009-February 2018, pathologically proven esNSCLC patients (T1-2N0M0) treated with CyberKnife as primary treatment alone and had pre and post-treatment PET/CT (in 3 weeks before and 12-16 weeks after SBRT) were retrospectively identified. The ΔSUVmax was calculated using formula ΔSUVmax. The area under the curve (AUC) was used to verify the accuracy; the product of maximum sensitivity and specificity was chosen as the cutoff value. Then, we stratified the study cohort above and below AUC and the survival data were estimated by Kaplan Meier method. Univariate and multivariate analyses were carried out by use of a Cox proportional hazards model.

      20c51b5f4e9aeb5334c90ff072e6f928 Results

      All patients’ clinicopathological and treatment characteristics are presented in the table. Median dose was 45 Gy/3 fr (range: 45-60 Gy/3-5 fr). According to EORTC metabolic response criteria, 8 (16.7%) patients achieved complete, and 35 (72.9%) patients achieved partial response. AUC was calculated as 0.62 for cutoff ΔSUVmax (sensitivity 79%, specificity 45%). ΔSUVmax was ≥0.62 in 7 of 8 patients with complete response and <0.62 in progressive 2 patients. At a median follow-up of 23 (range: 6-92) months local, regional and distant relapse had developed in 16 (33.3%), 11 (22.9%), and 16 (33.3%) patients, respectively. 29 (60.4%) patients were still alive at the time of analysis. Median PFS was 15 vs 59 months (p=.012) and median OS was 36 vs 70 months (p=.045). In univariate analysis, we could not find any significant effect of sex, age, KPS, T stage, and BED10 on PFS, and OS. In both univariate and multivariate analysis, the lower ΔSUVmax (as both dichotomous and continuous variable) was determined as a negative prognostic factor on PFS (p=.02, .003 for univatiate and .013 and .003 for multivariate) and it has been showed that the lower ΔSUVmax (only as a dichotomous variable) is a negative prognostic factor on OS in multivariate analysis (p=.009)

      Clinicopathological and treatment characteristics

      <0.62 n (%)≥0.62 n (%)
      Gender Female Male2 (6.5) 29 (93.5)2 (11.8) 15 (88.2)NSD
      Age at diagnosis (years) Median Range67 54-8467 56-82NSD
      KPS Median Range90 60-10080 60-90NSD
      Tumor Size (mm) Median Range27 15-4320 11-45NSD
      T stage T1 T221 (67.7) 10 (32.3)13 (76.5) 4 (23.5)NSD
      NSCLC histology Squamous Adenocarcinoma Other / unidentified13 (41.9) 8 (25.8) 10 (32.3)9 (52.9) 5 (29.4) 3 (17.6)NSD
      BED10 (Gy) Median Range112.5 100 - 180112.5 100 - 151NSD
      Local Failure Yes No12 (38.7) 19 (61.3)4 (23.5) 13 (76.5)0.04
      Regional Failure Yes No9 (29.0) 22 (71.0)2 (11.8) 15 (88.2)0.02
      Distant Failure Yes No14 (45.2)) 17 (54.9)2 (11.8) 15 (88.2)0.02
      Last Situation Alive Exitus16 (51.6) 15 (48.4)13 (76.5) 4 (23.5)0.04

      fd69c5cf902969e6fb71d043085ddee6 Conclusions

      ΔSUVmax is a prognostic factor in esNSCLC patients treated with SBRT and patients with higher ΔSUVmax (≥0.62) have better PFS and OS.

      b651e8a99c4375feb982b7c2cad376e9 Legal entity responsible for the study

      The authors.

      213f68309caaa4ccc14d5f99789640ad Funding

      Has not received any funding.

      682889d0a1d3b50267a69346a750433d Disclosure

      All authors have declared no conflicts of interest.


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