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W. Hanna



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    Epidemiology and outcomes (ID 57)

    • Event: ELCC 2018
    • Type: Poster Discussion session
    • Track:
    • Presentations: 1
    • Now Available
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      200PD - High physician confidence does not predict rate or type of treatment change for cases discussed at a thoracic multidisciplinary cancer conference: A case series in a tertiary cancer center (Now Available) (ID 602)

      10:59 - 10:59  |  Author(s): W. Hanna

      • Abstract
      • Slides

      Background:
      Multidisciplinary cancer conferences (MCCs) aim to improve the management of patients with cancer. We evaluated the rate and type of decision change that occurred at a thoracic MCC.

      Methods:
      The MCC took place from June-December 2017 at a Canadian tertiary cancer center and involved surgeons, oncologists, pathologists and radiologists. Cases were brought forward by treating physicians. Using a standardized MCC intake form, physicians articulated a clinical question, original treatment plan, and confidence in the original plan (rated on a 1–5 scale). Major changes were classified as: change from upfront surgery to neoadjuvant treatment, definitive chemotherapy/radiation, or Stereotactic Body Radiation Treatment/Radiofrequency Ablation (SBRT/RFA); change from neoadjuvant or definitive chemotherapy/radiation or SBRT/RFA to surgery; or palliation/observation instead of definitive treatment. Minor changes included additional imaging, further staging investigations, repeat consultations, or changes in planned oncologic or surgical approach. Data were reported as frequencies. Chi-square tests were used to compare groups at a p < 0.05 significance level.

      Results:
      A total of n = 116 cases were reviewed at the MCC. Ninety-six percent of cases required a re-review of imaging or pathology (111/116). Sixty percent (70/116) of cases resulted in a treatment change, with 41% (29/70) and 59% (41/70) of changes considered major and minor, respectively. High physician confidence in the original plan did not significantly correlate with the rate of change (53% no change; 47% change, p = 0.073) or type of change (30% major; 70% minor, p = 0.098). The most common major change was use of neoadjuvant or definitive chemotherapy/radiation instead of upfront surgery (38%, 11/29). Minor changes primarily involved further staging investigations (56%, 23/41).

      Conclusions:
      Sixty percent of cases discussed at the thoracic MCC resulted in a treatment change, with 41% considered major changes. High physician confidence did not significantly correlate with the rate or type of change. These data support the continued implementation and use of MCCs.

      Clinical trial identification:


      Legal entity responsible for the study:
      McMaster University

      Funding:
      Has not received any funding

      Disclosure:
      All authors have declared no conflicts of interest.

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    Poster Display session (Friday) (ID 65)

    • Event: ELCC 2018
    • Type: Poster Display session
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 4/13/2018, 12:30 - 13:00, Hall 1
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      127TiP - Phase I study of neo-adjuvant Stereotactic Body Radiotherapy (SBRT) in operable patients with borderline resectable locally advanced NSCLC (LA-NSCLC) (LINNEARRE I STUDY: NCT02433574) (ID 493)

      12:50 - 12:50  |  Author(s): W. Hanna

      • Abstract

      Background:
      Patients with NSCLC who undergo incomplete resection (R1) have significantly worse survival compared to those with complete resection (R0). The efficacy of Stereotactic Body Radiotherapy (SBRT) in treating small lung tumors is established, but its use as neo-adjuvant therapy in locally-advanced (LA)-NSCLC is not investigated. We hypothesized that pre-operative SBRT can be done safely and could improve rates of R0 resection in LA-NSCLC. This concept could introduce a rapid, convenient and less toxic neoadjuvant therapy in LA-NSCLC to help improve rates of complete resection. LINNEARRE I is single institution phase I study that investigates the safety and feasibility of delivering, timely, neo-adjuvant hypo-fractionated RT of escalating Biological Equivalent Doses (BED) approaching those of SBRT.

      Trial design:
      A total of twenty patients with biopsy proven T3-T4, N0-1, M0, NSCLC will be enrolled. Patients must be deemed as medically operable, by a thoracic surgeon, but at risk of
      Clinical trial identification:
      NCT02433574

      Legal entity responsible for the study:
      Juravinski Cancer Center

      Funding:
      Juravinski Cancer Center Foundation

      Disclosure:
      All authors have declared no conflicts of interest.