Author of

• 10692

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  P1.08 - Poster Session 1 - Radiotherapy (ID 195)

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

  • 10702

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    P1.08-010 - NSCLC and radiation pneumonitis post radiotherapy (ID 1132)

    09:30 - 09:30  |  Author(s): S. Brown
    • Abstract

    Background
    Lung cancer is the main cause of cancer deaths in the developed world and non-small cell lung cancer (NSCLC) accounts for 80-85% of all lung cancers [1]. Of these with NSCLC, 30-40% have locally advanced or inoperable disease, for which the mainstay of treatment remains thoracic irradiation. Radiation pneumonitis (RP) is one of the major dose limiting toxicities. The aim of this study is to retrospectively analyse the incidence and risk factors for RP in NSCLC patients treated with radiotherapy at Royal Hobart Hospital and to determine suitable dose restriction parameters.

    Methods
    273 patients with NSCLC who had radiotherapy treatment between 2006 and 2012 were retrospectively reviewed. For each patient, all records were examined for documented evidence of RP using the Common Terminology Criteria for Adverse Events (CTCEA 4.0 [2]) grading criteria at least six months post treatment. In addition, radiation dose, dose per fraction, planning target volume (PTV), total lung volume, mean lung dose, v5, v10, v20 and v30 values were obtained and a comparable biological effective dose (BED) for each treatment was calculated. Previous chemotherapy treatments, smoking status, performance status, use of ACE inhibitors, existing cardiovascular disease, established chronic obstructive pulmonary disease (COPD) and pulmonary function tests were also obtained.

    Results
    Out of the 273 NSCLC patients treated with radiotherapy at Royal Hobart Hospital, 25 (9%) had stage 1, 15 (5%) had stage 2, 75 (27%) had stage 3 and 129 (47%) had stage 4 NSCLC. 29 (11%) patients had no staging documented. 41 patients (15%) had documented evidence of RP. Of these 41 patients, 24 patients had level 1 RP, 14 patients had level 2, 1 patient had level 3, 1 patient had level 4 and 1 patient had level 5 (death). The mean BED (normalised to 2 Gy per fraction) was 64.9 +/- 21.0 Gy and the mean lung dose was 10.3 +/- 10.50 Gy. Twenty out of the 41 patients had been treated with radical intent and 21 with palliative intent.

    Conclusion
    In this study, RP has been documented in 15% of patients. More than half of these patients received palliative radiation dose. This could be explained by their advanced disease, poor lung function, and poor performance status. References: 1. Jemal A, Siegel R, Ward E, Hao Y, Xu J, Murray T, et al. Cancer statistics, 2008. CA Cancer J Clin 2008;58:71–96. 2. Common Terminology Criteria for Adverse Events (CTCEA 4.0), http://ctep.cancer.gov/protocolDevelopment/electronic_applications/ctc.htm