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EP1.01 - Advanced NSCLC (ID 150)
- Event: WCLC 2019
- Type: E-Poster Viewing in the Exhibit Hall
- Track: Advanced NSCLC
- Presentations: 2
- Now Available
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
EP1.01-70 - Reirradiation for Locoregionally Recurrent Lung Cancer: Outcomes in Non-Small Cell Lung Carcinoma (Now Available) (ID 1848)
08:00 - 18:00 | Author(s): Rajan Yadav
Locoregional failure in non-small cell lung cancer (NSCLC) remains high often leading to symptoms like hemoptysis and chest pain and the management for recurrent disease in the setting of prior radiotherapy is difficult. We retrospectively analyzed the outcomes for re-irradiation (reRT) for locoregionally recurrent lung cancer when used with intention of symptomatic relief in NSCLC.Method
This is a retrospective analysis of treatment of thirty-four patients of NSCLC who received re-irradiation to the thorax. All received re-irradiation by intensity-modulated radiotherapy. Palliative responses, survival outcomes, and prognostic factors were analyzed.Result
Median age of the group was 63 years, all but seven patients were males. All patients received a dose of 30.6 Gy in 17 fractions. Median survival of the group was 4.7 months, median KPS was 70. Relief of haemoptysis could be obtained in 31/34 assessable cases (91%), treatment was less effective for coughing 19/34 (56%) and dyspnoea 11/34 (32%). However, acute toxicities and new disease symptoms limited the duration of palliative benefit in the symptomatic NSCLC patients to a median of 2.3 months. No fatal complications were noted . Grade 2 or greater esophagitis was seen in 3/34(8%) cases.Conclusion
Reirradiation to the thorax for locoregionally recurrent NSCLC can provide palliative benefit. Select patients may experience meaningful survival prolongation after reirradiation. Careful selection of patients is necessary to avoid acute toxicity in already symptomatic patients. This experience demonstrates that repeated courses of radiotherapy can be given successfully and safely despite previous radical dosage.
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EP1.01-75 - Palliative Thoracic Radiotherapy for Lung Cancer: What Is the Most Appropriate Fractionation? (Now Available) (ID 325)
08:00 - 18:00 | Author(s): Rajan Yadav
Radiotherapy is the one of the most effective modalities to palliate the symptoms ( hemoptysis, pain, breathlessness) of poor-prognosis patients with advanced non-small-cell lung cancer. Most appropriate dose schedule however remains debatable. We conducted a retrospective analysis that compared the efficacy of radiotherapy schedules consisting of 5 fractions of 4 Gy (5 x 4 Gy) versus 10 fractions of 3Gy (10 x 3 Gy) in advanced Non Small Cell Lung Cancer (NSCLC). The end point evaluated was symptomatic relief.Method
Between July 2016 and September 2017, 60 patients with advanced NSCLC were randomised to either 5 fractions of 4 Gy (5 x 4 Gy):Arm A or 10 fractions of 3Gy (10 x 3 Gy):Arm B. The eligibility criteria was histologically or cytologically confirmed NSCLC, age > 30, stage III or IV disease, Karnofsky performance status (PS) > 40, expected survival > 3 months. The quality-of-life was assessed using the patient records :European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ)-C30 and the lung cancer–specific module QLQ-LC13. The primary study end points was control of symptoms viz cough, hemoptysis, pain and dyspnea, and the secondary end point was to evaluate Overall Survival (OS).Result
52 out of 60 patients were males,18/60 had lost to follow up. Majority of patients presented in 5th and 6th decade of their lives, mean age of presentation was 58.87 (Range31-80). Majority (69%) of patients had presented with poor KPS 70 or less. Most common presenting symptom was cough with expectoration (74.66%) followed by hemoptysis (47.33%). Post treatment 36% reported reduced cough, 44% reported reduced dyspnea, 57% reported reduced pain and 90% reported reduced hemoptysis within 20 weeks from start of treatment, with no statistical difference among the groups. Except for improved hemoptysis at week 5 in Arm A (P =0.03), there was no difference among the groups. Furthermore, the palliative effect of symptoms seemed to last throughout the planned follow-up period. Overall survival for all patients (n=42) revealed no significant survival difference among the treatment groups (P = 0.2). The median survival was 6.2 and 6.7 months in arm A and B, respectively.Conclusion
Hypofractionated regimen of 20Gy/5 fractions is atleast as effective at providing symptomatic relief and yields equivalent survival as 30Gy/10 fractions in patients with advanced non-small cell lung cancer and thoracic symptoms besides having the advantage of fewer visits to hospital as well.