Author of

• 10720

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  P1.09 - Poster Session 1 - Combined Modality (ID 212)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Combined Modality
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/28/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 10724

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    P1.09-004 - Feasibility and efficacy of inductive chemo or chemoradiation for patients with locally advanced non-small cell lung cancers and reduced respiratory function (ID 297)

    09:30 - 09:30  |  Author(s): N. Tuset Der-Abrain
    • Abstract

    Background
    Half of non-small cell lung cancers are diagnosed a locally advanced stage (LA-NSCLC) and are treated by combining chemotherapy, radiation, and surgery (S). However, many patients are not able to receive complete multidisciplinary therapies due to previous respiratory dysfunctions. We report the feasibility and efficacy of inductive chemotherapy (iCT) or chemoradiation (iCRT) followed by S or consolidative radiation (RT) in LA-NSCLC patients with normal (NRF) and reduced respiratory function (RRF)

    Methods
    We retrospectively reviewed 100 LA-NSCLC ECOG-0-2 patients treated with iCT or iCRT followed by S or RT in our center between October-2004 and June-2012. No patient was excluded to receive treatment due to RRF, but all those without initial determination of basal forced expiratory volume in the first second (FEV1) were not analyzed. Patients were classified into two groups according to initial FEV1: 1) NRF FEV1≥ 60%, and 2) RRF FEV1< 60%. A comparison of toxicity, compliance, treatment modality, and outcome between these groups was performed

    Results
    Seventy-two patients initially presented NRF, and 28 RRF. Seventy (97.2%) patients with NRF completed curative treatments (20 iCRT+S; 20 iCRT+RT; 19 iCT+S; and 11 iCT+RT). Twenty-six patients (92.8%) with RRF completed curative treatments (3 iCRT+S; 14 iCRT+RT; 3 iCT+S; and 6 iCT+RT). The rest of them progressed during inductive treatment and did not receive curative approaches. Any patient interrupted the treatment due to toxicity. Resection rate was lower among patients with RRF (55.7% vs. 23%, p= 0.004), but tolerance to S was similar to those with NRF (p= 0.72). RT was applied in 44.2% and 76.9% of patients with NRF and RRF, respectively. Incidence of grade 3-4 toxicities was similar in both groups of patients (13.9% vs. 11%; p= 0.72). There were no significant differences in disease free survival (16 vs. 21.8 months, p= 0.689), but overall survival paradoxically trended to be better in patients with RRF (27.4 vs. 37.3 months, p= 0.066)

    Conclusion
    RRF does not necessarily contraindicate a multidisciplinary curative approach for LA-NSCLC. In our series, iCT and iCRT were followed by S in 23% of patients with RRF, and by RT in 77%. Outcome of patients with RRF receiving an intentionally curative treatment was at least as good as that of patients with NRF. Figure 1. Kaplan-Meier DFS and OS curves according to initial FEV1. Figure 1