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

  • 10713

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    P1.08-021 - Outcomes of Stereotactic Body Radiation Therapy for Stage I Non-Small Cell Lung Cancer and Pulmonary Metastases. (ID 2578)

    09:30 - 09:30  |  Author(s): J. Lam
    • Abstract

    Background
    Stereotactic ablative body radiotherapy (SABR) can achieve high local control rates in patients with Stage I non-small cell lung cancer (NSCLC) and pulmonary metastases. We report the outcomes of patients treated at Royal North Shore Hospital between January 2010 and January 2012.

    Methods
    Patients were discussed in a multi-disciplinary meeting and were medically inoperable, or refused surgery. Lesions were divided into central or peripheral zone lesions. Peripheral lesions received 48 Gy in 4 fractions, and central lesions 50 Gy in 5 fractions. Minimum coverage was 98% of the target to receive the prescribed dose. Treatment was delivered on a Varian Clinac with 7-10 field IMRT. Toxicity was graded according to CTC-AE version 4.0.

    Results
    Patient Characteristics Thirty-four lesions were treated in 27 patients. Eleven patients (41%) had Stage I NSCLC, 15 (56%) pulmonary metastases, and 1 patient presented with synchronous primary NSCLC and brain metastases. The commonest primary site for pulmonary metastases was colorectal cancer (n=6). The median age was 72 years. Sixty-seven percent (n=18) of patients were medically inoperable with the other patients refusing surgery. Radiotherapy Dosimetry Eighteen tumours received 48 Gy in 4 fractions, and 12 tumours received 50 Gy in 5 fractions. Three patients with multiple lesions received 18 Gy in 1 fraction to their third lesion. One patient, with a tumour adjacent to the brachial plexus, received 49 Gy in 7 fractions. Survival With a median follow-up period of 24 months, 4 patients with pulmonary metastases and 3 patients with primary NSCLC have died. In patients with pumonary metastases the first site of failure was distant in 5 patients and pulmonary in 5 patients, with 1 in-field recurrence. In NSCLC patients there were 4 pulmonary recurrences, 3 of these were in-field. Two patients have developed metastatic disease. The median time to first event was 18 months in NSCLC patients and 7 months in patients with pulmonary metastases. Figure 1 Toxicity Two patients developed grade 2 pneumonitis. Grade 1 chest, dyspnoea or cough were seen in 7 patients. No other toxicity was seen.

    Conclusion
    Our data support the increasing use of SABR lung as an effective and non-toxic treatment. However, there were a number of local recurrences in NSCLC patients occurring after 15 months, supporting the need for long-term follow-up. In patients with pulmonary metastases the median time to further disease progression was 7 months- more rigorous patient selection may help to identify patients in whom SABR lung will be most beneficial.