Author of

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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

  • 34964

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    P05.06 - Stereotactic Ablative Radiotherapy for Early Stage Non-Small Lung Cancer and Pulmonary Oligometastases in a New Zealand Population (ID 3611)

    00:00 - 00:00  |  Presenting Author(s): Nur Azri Bin Haji Mohd Yasin
    • Abstract
    • Slides

    Introduction
    

    Stereotactic ablative radiotherapy (SABR) is increasingly becoming the standard of care for treating medically inoperable early stage non-small cell lung cancer (NSCLC) and small lung oligometastses, with good local control rates in the region of 85-86% at 3 years. The recurrence-free survival after SABR at 3 years is about 42%-48%. The aim of this study was to compare the outcomes of lung based SABR in a New Zealand cohort to the global literature.

    Methods
    

    A single-institution retrospective analysis was performed on all patients who received lung-based SABR between May 2015 and September 2019 at Waikato Hospital, New Zealand. The study included both early stage lung cancer and lung oligometastases that measured less than 5cm. Statistical analysis was executed using Microsoft Excel and IBM SPSS Statistics Subscription version 1.0.0.1327. Kaplan-Meier method was used to report local control, progression-free survival and overall survival.

    Results
    

    102 patients received SABR to 116 lesions. 86 (74%) of the lesions were considered early stage lung cancer and 30 (26%) were considered metastatic disease to the lung. Median follow-up was 19 months. The most common dose received, in 50% of the cohort, was 48Gy in four fractions. 30% received 60Gy in eight fractions and 10% received 54Gy in three fractions. All delivered two fractions per week over two weeks. 10% were prescribed different dose fractionation based. The three-year rate of local control was 85% and 82% in the primary and metastatic cohorts respectively. Central primary lung cancer was associated with a higher risk of local recurrence (HR6.4 p=0.02). The three-year progression-free survival rate in patients with early stage lung cancer and oligometastases was 56% and 26% respectively. The first site of recurrence in patients with early stage lung cancer was local in 22% and regional or distant in 78%. Maori patients with primary lung cancer had a significantly worse progression free survival (HR2.4 p=0.03). The three-year overall survival rate in patients with early stage lung cancer and oligometastases was 71% and 73% respectively. There were no reported grade three and above toxicities.

    Conclusion
    

    The use of SABR for early non-small cell lung cancer and pulmonary oligometastases in a typical radiotherapy setting in New Zealand is comparable to global outcomes. While local control is good with SABR, the progression free survival at three years is about 42-56%. Research focus on adjuvant treatment after lung SABR for early non-small cell lung cancer is warranted.

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