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  Mini Oral session III (ID 65)

  • Event: ELCC 2019
  • Type: Mini Oral session
  • Track:
  • Presentations: 1
  • Moderators:
  • Coordinates: 4/12/2019, 17:45 - 18:45, Room C

  • 29191

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    71O - Impact of underlying pulmonary diseases on treatment outcomes in early stage non-small cell lung cancer treated with definitive radiotherapy (ID 152)

    17:45 - 18:45  |  Author(s): Hongryull Pyo
    • Abstract
    • Presentation
    • Slides

    Background
    

    Current guidelines recommend definitive radiotherapy for patients with medically inoperable early stage non-small cell lung cancer (NSCLC). However, impact of underlying pulmonary diseases on survival of those patients are unclear. Especially, although the patients with COPD and lung cancer have worse prognosis than those without COPD regardless tumor stage, the impact of coexisting COPD on treatment outcome after definitive radiotherapy has not been fully investigated. Thus, we aimed to evaluate the impact of underlying chronic pulmonary disease of COPD, IPF, and CPFE on treatment outcome following definitive radiotherapy in patients with medically inoperable stage I-II NSCLC.

    a9ded1e5ce5d75814730bb4caaf49419 Methods
    

    We retrospectively reviewed the medical records of 234 patients with stage I-II NSCLC treated with definitive radiotherapy alone at Samsung Medical Center, between January 2010 and October 2017. We compared the survival outcomes according to the presence of underlying pulmonary diseases of chronic obstructive pulmonary disease (COPD), combined pulmonary fibrosis and emphysema (CPFE), and idiopathic pulmonary fibrosis (IPF). In current study, we defined control group as non-COPD, non-CPFE, and non-IPF.

    20c51b5f4e9aeb5334c90ff072e6f928 Results
    

    Among 234 study patients, 132 (56.4%) were diagnosed with COPD, 16 (6.8%) with CPFE, and 22 (9.4%) with IPF. The median follow-up duration was 17 months (range, 1 to 92 months). The median survival of control, COPD, CPFE, and IPF groups were 32, 49, 17, and 12 months, respectively (P < 0.001). In a Cox proportional hazards analysis for factors associated with overall survival, patients with COPD showed similar risk of death (Adjusted HR, 1.314; 95% CI, 0.677-2.551; p-value= 0.419) compared to control group, while patients with IPF (Adjusted HR, 3.539; 95% CI, 1.647-7.607; p-value= 0.001) and CPFE (Adjusted HR, 2.669; 95% CI, 1.095-6.505; p-value= 0.031) showed increased risk of death.

    fd69c5cf902969e6fb71d043085ddee6 Conclusions
    

    Definitive radiotherapy may be a tolerable treatment for early-stage NSCLC with COPD. However, the poor survival in early-stage NSCLC patients with co-existing IPF or CPFE warrants further study to identify and develop patient selection criteria and optimal radiotherapy modality.

    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.

    cffcb1a185b2d7d5c44e9dc785b6bb25

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