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K.H. Hansen
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P2.07 - Poster Session/ Small Cell Lung Cancer (ID 222)
- Event: WCLC 2015
- Type: Poster
- Track: Small Cell Lung Cancer
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.07-015 - Pattern of Failure after Definitive Radiotherapy for Small Cell Lung Cancer (ID 2423)
09:30 - 09:30 | Author(s): K.H. Hansen
- Abstract
Background:
The standard of care for limited disease SCLC is chemo-radiotherapy. The recommended radiotherapy schedule is 45 Gy/30 F bi-daily (BD-RT) for patients in good performance status according to various guidelines. However, a large proportion of these patients are not able to fulfill the bi-daily schedule due to frailty. For these patients 45 Gy/25 F, once-daily (OD-RT) has been the standard of care at our institution. The aim of this study was to investigate the pattern of failure and survival after chemo-radiotherapy with the 2 different radiotherapy schedules.
Methods:
Records of 106 patients with limited disease SCLC treated from 2007 to 2013 with definitive chemo-radiotherapy in our institution were reviewed. The chemotherapy regimen was a platinum doublet with etoposide. The radiotherapy schedule for 69 patients was treatment OD-RT (45 Gy/25 F), whereas 37 patients were treated BD-RT (45 Gy/30 F). Log rank tests were used to compare overall survival (OS) and local failure free survival (LFS) between the groups.
Results:
In the OD-RT 23 patients (33%) were either alive or dead without evidence of recurrence, and 15 patients (41%) in the BD-RT. In the OD-RT 21 patients (30%) had locoregional recurrence only, 12 patients (17%) had locoregional and distant relapse, and 13 patients (19%) had distant metastasis only. In the BD-RT 8 patients (22%) had locoregional recurrence only, 8 patients (22%) had locoregional and distant failure, and 6 patients (16%) had distant relapse only. Statistically significant (p<0,05) differences in patient characteristics between the two groups were observed: fraction of Performance Status 0-1 93% vs 67%, fraction treated with PCI 78% vs 54% and mean age of 62 vs 67 years for the groups BD-RT and OD-RT respectively. No differences were observed in S-sodium, LDH or gender. The mean follow-up was 24 months. Median overall survival was 18 months in OD-RT and 24 months in BD-RT, and 2 year OS was 45% vs 43% respectively (p=0.23). Median local-failure free survival was 13 months in OD-RT vs 33 months in BD-RT, and 2 year LFS was 57% vs 40% respectively (p=0.19) Local failure free survuval: Figure 1
Conclusion:
In this study the locoregional control and overall survival was not significantly better in the bi-daily regimen with 45 Gy/30 F compared to once-daily treatment with 45 Gy/25 F. This was unexpected, because the two groups differed significantly in PS, PCI and age in favour of the bi-daily regimen. But the size sample was small and follow-up time short.
