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Yeonsil Kim
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P05 - Early Stage/Localized Disease - Radiotherapy (ID 114)
- Event: WCLC 2020
- Type: Posters
- Track: Early Stage/Localized Disease
- Presentations: 1
- Moderators:
- Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
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P05.01 - Multicenter Retrospective Study of Stereotactic Body Radiotherapy in Non-Small Cell Lung Cancer in South Korea (KROG 17-09) (ID 2033)
00:00 - 00:00 | Author(s): Yeonsil Kim
- Abstract
Introduction
Korean radiation oncology group conducted a multicenter retrospective study to evaluate the clinical outcomes of stereotactic body radiotherapy (SBRT) in patients with early stage non-small cell lung cancer (NSCLC) (KROG 17-09).
Methods
From 10 major academic centers, a total of 234 patients with newly diagnosed T1-2N0M0 NSCLC patients from 2005 to 2014 were included. Most were diagnosed pathologically (N=213, 91.0%). Seventeen patients (7.3%) were confirmed as N0 using pathologic mediastinal lymph node evaluation, while the others (92.7%) were confirmed as N0 radiologically. The patients who received additional surgery or systemic therapy were excluded. Various SBRT schedules were used in each center. The median radiation dose and fraction size were 60 Gy (range, 40-70 Gy) and 12 Gy (range, 5-20 Gy), respectively. The representative dose schedules are as follows; 60 Gy/4 fractions, 60 Gy/5 fractions, 48 Gy/4 fractions and 54 Gy/3 fractions in 67 (28.6%), 40 (17.1%), 31 (13.2%) and 16 (6.8%) patients, respectively. Disease failures were categorized as local, regional, and distant, defined as the evidence of progressive soft tissue abnormalities, any intrathoracic lymph node recurrence, and contralateral or extra-thoracic failure, respectively.
Results
The median age was 76.5 years (range, 44-91 years), and the majority were male (N=180, 76.9%). While 152 patients (65.0%) had an ECOG performance status of 0 to 1, 82 (35.0%) had an ECOG of 2 to 3, and 120 (51.3%) had underlying lung disease. The median tumor size was 25 mm (range, 7-58 mm), and 154 patients (65.8%) were T1 according to 7th AJCC staging system. After the median follow-up of 28.5 months, 84 patients (35.9%) had disease failure; local failure in 39 (16.7%), regional failure in 27 (11.5%) and distant failure in 52 (22.2%). Among 39 local failures, 29 (12.4%) were in-field/marginal failures, and the other 10 (4.3%) were out-field failures at the same lobe. The 3-year primary tumor control, local control, regional control and distant control was 85.5%, 79.9%, 83.3% and 75.3%, respectively. The 3-year overall survival, cancer-specific survival and disease-free survival was 54.1%, 66.9% and 43.2%, respectively. Grade ≥3 treatment-related toxicities were reported in 16 patients (6.9%).
Conclusion
In this study, we were able to report the characteristics and clinical outcomes of SBRT in patients with early stage NSCLC in South Korea. We could confirm that the SBRT is a relatively safe and effective treatment modality. The results would be a meaningful reference to set future research directions.
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P24 - Mesothelioma, Thymoma and Other Thoracic Malignancies - Mesothelioma Clinical and Trials in Progress (ID 138)
- Event: WCLC 2020
- Type: Posters
- Track: Mesothelioma, Thymoma and Other Thoracic Malignancies
- Presentations: 1
- Moderators:
- Coordinates: 1/28/2021, 00:00 - 01:00, ePoster Hall
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P24.01 - Entire Pleural Intensity-Modulated Radiotherapy in a Neoadjuvant Setting for Resectable Malignant Mesothelioma (ID 1159)
00:00 - 01:00 | Presenting Author(s): Yeonsil Kim
- Abstract
Introduction
The purpose of this study is to evaluate the safety and efficacy of the multimodality treatment with neoadjuvant chemotherapy and intensity-modulated radiotherapy (IMRT) for resectable clinical T1-3N0-1M0 malignant pleural mesothelioma (MPM) in single tertiary center.
Methods
Total twenty eight patients who received neoadjuvant chemotherapy and radiotherapy between March 2016 and September 2019 were reviewed. Patients received 25Gy in five fractions to entire ipsilateral hemithorax. All patients were treated with helical tomotherapy. Median age of patients were 56 years old. Epitheloid subtype was found as a main except three (two biphasic, one desmoplastic sarcomatoid variants). All patients received neoadjuvant chemotherapy with pemetrexed-cisplatin (AP) regimen. All of patients completed 25Gy/5fxs of RT.
Results
IMRT was well tolerated with two acute grade 2, one of grade 3 radiation pneumonitis. Surgery was performed one week (median 8 days) after completing IMRT. Extrapleural pneumonectomy (EPP) was performed in 18 patients, and pleurectomy and decortications (PD) in 10. There was no grade 3+ surgical complication except three deaths after EPP in 90 days. Based on operative findings and pathologic staging, mainly adjuvant chemotherapy was delivered and added adjuvant radiotherapy in seven patients with high risk of local recurrence. By a interim analysis, there were three local recurrence and three distant metastasis even short follow-up period (median 13.5 months).
Conclusion
In summary, neoadjuvant entire pleural intensity-modulated radiotherapy (IMRT) can be delivered with a favorable radiation complication. An optimal strategy has to be made in resectable MPM patients who would benefit from neoadjuvant chemotherapy and radiation followed by curative surgery. Further studies are needed to look at long-term outcomes.
