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Lin Zhou
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P20 - Locoregional and Oligometastatic Disease - Radiation (ID 130)
- Event: WCLC 2020
- Type: Posters
- Track: Locoregional and Oligometastatic Disease
- Presentations: 1
- Moderators:
- Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
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P20.01 - Stereotactic Body Radiation Therapy for Residual Primary Lesions after First Line Treatment for Advanced Non-Small Cell Lung Cancer (ID 1585)
00:00 - 00:00 | Presenting Author(s): Lin Zhou
- Abstract
Introduction
For non-small cell lung cancer (NSCLC), stereotactic body radiation therapy (SBRT) is commonly carried out for the primary lesions of early stage patients with operational contraindications, or oligometastases of advanced stage patients. In this retrospective study, efficacy and toxicities of SBRT for residual primary lesions after the first line treatment for advanced NSCLC have been evaluated, and satisfied response has been observed.
Methods
From May 2017 to Dec. 2018, totally 33 stage IV NSCLC patients with residual primary lesions received SBRT after first line treatment were enrolled. patients' characteristics included: ages between 44 to 80 years (the median of 61 years); eighteen male and 15 female; twenty-seven adenocarcinoma and 6 squamous cell carcinoma. Sixteen patients received tyrosine kinase inhibitors (TKIs), 14 patients received platinum based chemotherapy, and 3 patients received immune checkpoint inhibitors (ICIs) as the first line treatment. Residual primary lesions after 4-6 cycles of chemotherapy or stabilized between 3 continuously CT scanning during TKIs and ICIs treatment received SBRT (40-60Gy/5-7f).
Results
Totally 33 residual primary lesions, with the greatest diameters of 1-4cm (the median of 2cm), received SBRT. AT the end of follow-up (Feb.2020), the median follow up time was 16 months. The objective response rate, disease control rate, and median progression free survival (PFS) of whole patients were 81.8% (27/33), 100% (33/33), and 14 months. Nineteen patients had disease progression, and the first site of progression included 2 (10.5%) patients of radiated lesions progressed, 10 (52.6%) patients of new metastases in lungs, and 7 (36.8%) patients of distant metastases. both the overall survival (OS) and local progression free survival (LPFS) were 4-36 months, and the median times were not reached. Two patients died with the OS of 5 and 15 months, and 7 patients had radiated lesions progressed with the LPFS of 4-22 months. 62.5% (20/32) of patients had lung fibrosis experience in the radiated area of lungs. Grade 1 radiation esophagitis, grade 1 fatigue, grade 1 anorexia, grade 2-3 radiation pneumonitis, and radiation-induced rib fracture were observed in 9.1% (3/33), 15.2% (5/33), 18.1% (6/33), 18.1% (6/33), and 3% (1/33) of patients.
Conclusion
SBRT for residual primary lesions after first line treatment for advanced NSCLC was tolerable with satisfied response, and the prospective trials are needed to verify its efficacy.
