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W. Zhang



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    P2.08 - Poster Session 2 - Radiotherapy (ID 198)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Radiation Oncology + Radiotherapy
    • Presentations: 1
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      P2.08-026 - Prospective Study of Stage I Non-Small-Cell Lung Cancer Treated with Hypofractionated SIB IMRT (ID 3026)

      09:30 - 09:30  |  Author(s): W. Zhang

      • Abstract

      Background
      To analyze the effects of hypofractionated-simultaneous integrated boost-intensity modulated radiation therapy (Hypo-SIB-IMRT) on medically inoperable patients with stage I non–small-cell lung cancer (NSCLC).

      Methods
      65 qualified patients from December 2003 to November 2012 at three centers in China were included, with a median follow-up time of 39 months. Hypo-SIB-IMRT was delivered in 15 fractions with iGTV 75Gy, CTV 60Gy, and PTV 45Gy in 3 weeks. The slow computer tomography (CT) scan, conventional planning CT scan with active breath control (ABC), [18]fluorodeoxyglucose-position emission tomography ([18]FDG-PET) scan, or four dimensional CT scan (4D CT) were employed to do simulation. During the treatment, electrical port imaging device (EPID) or cone beam CT (CBCT) were performed 2-3 times per week to verify the reproducibility of the targets. All IMRT plans were optimized with Pinnacle or Eclipse systems using heterogeneity correction.

      Results
      The 1-, 3- and 5-year overall survivals (OS) were 100%, 87% and 58%, respectively with a median survival of 66.5 months. The 1-, 3- and 5-year progression free survivals (PFS) were 98%, 83% and 74%, while cancer-specific survivals (CSS) were 100%, 92% and 73%, respectively. The distant metastasis-free survivals (DMFS) were 98%, 85% and 76%, meanwhile local control (LC) were 100%, 93%, and 91%, respectively. There were no significant differences in OS, PFS, CSS, DMFS and LC compared with stage (I~A~ vs. I~B~) or gross tumor volume (GTV＞20 cm[3] vs.≤20 cm[3]). However, patients with T~1~ tumors (stage I~A~) were inclined to better survivals than those with T~2a~ (stage I~B~) ones, and local relapses were more frequent for larger GTVs. 18.5% (12/65) had grade 1or 2 radiation pneumonitis (RP), and only 1.5% (1/65) grade 1 esophagitis. Of 12 patients with RP, 10.8% (7/65) developed grade 1 radiation pulmonary fibrosis (RPF).

      Conclusion
      Due to the favorable long-term OS, PFS, CSS, DMFS, LC in addition to the minimal toxicities for medically inoperable stage I NSCLC patients, Hypo-SIB-IMRT presented in this prospective study may be an option to stereotactic body radiotherapy.