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Katharine Thomas
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P49 - Small Cell Lung Cancer/NET - Radiotherapy (ID 237)
- Event: WCLC 2020
- Type: Posters
- Track: Small Cell Lung Cancer/NET
- Presentations: 1
- Moderators:
- Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
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P49.04 - The use of Stereotactic Body Radiotherapy in Pulmonary Carcinoid Tumors: A Single Institution Retrospective Review (ID 3108)
00:00 - 00:00 | Presenting Author(s): Katharine Thomas
- Abstract
Introduction
Pulmonary carcinoid (PC) tumors are rare neoplasms that account for 1-2% of lung cancers and have an annual incidence of 2 per 100,000. The majority of PC malignancies are typical carcinoid (TC) tumors that are well differentiated and slow growing, however, others may present as more aggressive atypical carcinoid (AC) tumors with necrosis and higher mitotic indices. Although surgical resection is standard treatment for PCs, not all patients are surgical candidates due to underlying medical conditions, metastatic disease, or patient preference. Stereotactic body radiotherapy (SBRT) is an effective way to deliver curative intent radiation, commonly to inoperable non-small cell lung cancer. There is a paucity of data looking at SBRT in PCs. We aimed to review the outcomes of patients with PCs who were treated with SBRT at our institution.
Methods
All patients with a diagnosis of a PC who were seen in our clinic from 4/2013-7/2020 were identified and the charts of those who received SBRT were retrospectively reviewed. Patients with a pathological diagnosis and who had pre and post treatment imaging were included. Patient demographics, pathologic characteristics, radiographic assessment, and treatment course and outcomes were collected. Response rate was determined by the Response Evaluation Criteria in Solid Tumors (RECIST) criteria.
Results
Seven patients were identified as having PCs, and received 8 SBRT courses. All patients were female with a median age of 65 years. Six patients (86%) had an Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0, while 1 patient was an ECOG PS of 1 (14%). All patients had a primary PC. Six (86%) had TCs. All patients had T1 disease; T1a, 3(43%), T1b, 1(14%), T1c 3(42%). At the time of PC diagnosis, 1 patient was stage 1A2 (14%), 1 patient was stage IIB (14%), 1 patient was stage IVA (14%), and 4 patients were stage IVb (57%). Other sites of disease were liver in 4 patients (57%) and super hilar lymph node recurrence in 1 patient (14%). Of the 5 patients with distant disease at diagnosis, SBRT was used for local control for enlarging primary tumors in the setting of stable distant disease in each of these cases. SBRT dosing consisted of 42-60 Gy over 3-8 fractions. At the median follow up time of 13.8 months (range 8.9-25.7 months), local control was achieved in all 8,(100%) PC tumor sites. A complete response was achieved in 2 patients (29%), partial response was seen in 4 patients (57%), and 1(14 %) patient had stable disease. Two, (29%) patients have since died of distant disease. There were no adverse events reported from this treatment modality.
Conclusion
Our study shows that SBRT is a safe alternative treatment for patient with PC tumors. SBRT in PCs provides excellent local control even in the setting of advanced disease. It is reasonable to consider SBRT in patients with PC who are ineligible for surgical resection due to comorbidities, tumor burden, personal preference, or advanced disease. Prospective studies are warranted to further investigate the role of SBRT in PC tumors.
