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

  • 10707

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    P1.08-015 - Comparision of Once-daily vs Twice-daily Thoracic Radiotherapy Outcomes in Limited Disease Small Cell Lung Cancer Treated Concurrently With Cisplatin and Etoposide : A Single Institution Retrospective Analysis (ID 1794)

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

    Background
    To evaluate and compare outcomes of two fractionation scheme of thoracic radiotherapy(once-daily vs twice daily), concurrently with cisplatin and etoposide(EP) in limited disease small cell lung cancer(LD-SCLC).

    Methods
    LD-SCLC patients treated with definitive chemoradiotherapy at Seoul St. Mary’s Hospital were reviewed. Total 51 patients received radiotherapy concurrently with EP, after initially starting 1~2 cycle of EP. Once-daily group (33 patients) irradiated total 50~56 Gy in 28~32 fractions, and twice-daily group (18 patients) irradiated 45 Gy in 30 fractions. Subsquently, additional 1~2 cycles of EP was given. After CRT, 38 patients who get remission in thorax, received prophylactic cranial irradiation(PCI). PCI consisted of total 24~30 Gy over a 2-weeks period.

    Results
    Median follow-up duration is 47.5 months. 2-year overall survival(OS) rate of all patient was 61.2 % (median 27.4 months). 2-year OS rate was higher (83.9%) in once-daily group, compared with twice-daily group (53.1%), but there were no statistically significant difference (p=0.071). After CRT, 47 patients (93%) had partial to complete remission, but 30 patients were eventually progressed or recurred. Main failure pattern was distant failure (46.7%). The trend of higher loco-regional failure (50%) was detected in twice-daily group compared with once-daily group (30%), but there was no statistically difference between two groups (p=0.055). 7 brain metastasis were detected in once-daily group and 2 in twice-daily group, but there was no statistically difference between two groups (p=0.184). In subgroup analysis of 38 PCI patients, brain metastasis rate were not statistically differ from two groups (once-daily; p=0.171, twice-daily; p=0.146). There were also no significant differences of 2-year progression free survival(PFS), loco-regional disease free survival(LRDFS) and distant metastasis free survival(DMFS) between groups(PFS; p=0.541, LRDFS; p=0.238, DMFS; p=0.792), and no statistically differences in acute toxicities(non-hematologic p=0.128, hematologic p=0.277).

    Conclusion
    Our results showed no statistically significant differences between two groups, although showing relatively higher OS rate and lower brain metastasis in twice-daily group favoring twice-daily radiation scheme and the trend of higher loco-regional failure in twice-daily group. It could be clues for considering thoracic radiation dose escalation above 45 Gy in twice-daily scheme to lower loco-regional failure. Small patients number and short follow up duration of twice-daily group could be the factor and limitation of the results causing these low statistical power. Further long term evaluation and analysis of comparing two groups could be important in that points.