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Cameron Angus Keogh



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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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      P20.05 - Oesophageal Dose Predicts on Treatment Toxicity in Patients Receiving Concurrent Chemo-Radiotherapy for Non-Small Cell Lung Cancer (ID 2976)

      00:00 - 00:00  |  Presenting Author(s): Cameron Angus Keogh

      • Abstract
      • Slides

      Introduction

      Previous studies suggest that there is a relationship between radiotherapy dose and organ toxicity in patients receiving radical radiotherapy for lung cancer.

      We aimed to establish the incidence of toxicity from 3D conformal radiotherapy and describe the associations between radiotherapy dose and gastrointestinal toxicities.

      Methods

      We conducted a retrospective analysis of radiation doses and toxicities in 72 patients with stage 3 NSCLC who received concurrent chemoradiotherapy at the Edinburgh Cancer Centre between 2016 and 2017. Patients received 60Gy in 30 fractions of external beam radiotherapy, with concurrent cisplatin and vinorelbine. Patients underwent a weekly nurse led toxicity assessment and CTCAE gradings were recorded. 64 patients had both accessible radiotherapy treatment data and toxicity tables, and were included in the statistical analysis of toxicities. For the purpose of this study GI toxicities entailed: dysphagia, oesophagitis, nausea, vomiting, anorexia and weight loss. 5 patients were excluded as they had no radiotherapy data available and 3 patients were excluded as they had no toxicity data. We then conducted a single-tail t-test of the mean difference in OesV100 dose between patients with GI toxicities of 2 or above, and those with GI toxicities of 1 or less.

      Results

      The median age of patients was 64 years old (range 42-78) and 56% were male and 44% were female. 67 patients (93%) had radiotherapy plans available. Lung V20 & MLD (Mean Lung Dose), OesV100, Heart V30, and Heart V5 were all recorded. 69 (96% of patients) had toxicity tables from the 6 weeks of treatment, and 55 (75%) had follow-up toxicities noted at week 10. 13 patients did not have follow-up toxicities readily available as they had returned to a different health board.

      Of the 64 patients included in the statistical analysis, 33 had a toxicity of grade 2 or above at any point during treatment or follow-up. This group had a statistically significant mean difference (MD) in Oesophageal V100%, compared to those without any grade 2 toxicity (V100% of 6.9% vs 2.5%, 95% confidence interval of MD, 0.45 to 8.2; P value of 0.0146). When only GI toxicities were considered (n=43) the mean Oesophagus V100% of this group was 7.6% vs 2.63% (95% CI of MD, 1.2% to 8.9%; P-value 0.0134). Lung V20, MLD, Heart V30 and Heart V5 did not show any relationship with Grade 2 or higher toxicity.

      Conclusion

      1. Toxicity grades were well documented during patients’ 6-week period of radiotherapy.

      2. We found an association between OesV100 dose, and any grade 2 or above toxicity, as well as with GI toxicities.

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