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F. De Ryck
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P3.02 - Poster Session/ Treatment of Localized Disease – NSCLC (ID 211)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Localized Disease - NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P3.02-040 - PEARL: Pathologic Effect of NeoAdjuvant Stereotactic Ablative Body Radiotherapy (SABR) in Operable Early Stage Lung Cancer (ID 918)
09:30 - 09:30 | Author(s): F. De Ryck
- Abstract
Background:
SABR is considered a valid alternative to surgical resection in stage IA NSCLC (Senan, TLO 2013). However, doubts persists regarding the risk of local recurrence as lymph node staging is suboptimal and the completeness of pathological response is not verified (Van Schil, TLO 2013).
Methods:
We conducted a prospective phase 2 trial in functionally operable patients with NSCLC, staged cIA after PET/CT and endosonographic staging, who provided informed consent for neoadjuvant SABR, followed by VATS resection of primary tumour and draining lymph nodes.
Results:
We report on 1 patient, after which the trial was prematurely closed. This 57 year old smoker was incidentally diagnosed with a cT1bN0M0 adenocarcinoma in the middle lobe (2.9 x 2.1 cm) and EBUS-confirmed tumour-free ipsilateral hilar and mediastinal lymphnodes. 3 weeks after receiving 20 Gray on the tumour bed on days 1/4/7 each, he underwent a VATS middle lobectomy with systematic lymph node sampling. The resection specimen showed a completely resected 2.5 cm vital adenocarcinoma with invasion of 1/3 hilar lymph nodes (ypT1bpN1M0R0Pl0). 4 cycles of adjuvant cisplatin-based chemotherapy were uneventfully administered and patient remains in complete remission 4 years after resection.
Conclusion:
This prospective case report challenges the completeness of pathological response and of lymph node staging with SABR. Comprehensive bio-imaging will be presented at the meeting.
