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G. Thomas



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    P3.08 - Poster Session 3 - Radiotherapy (ID 199)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Radiation Oncology + Radiotherapy
    • Presentations: 1
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      P3.08-022 - Survival analysis of Hypo-fractionated Radical Radiotherapy for the treatment of Non-Small-Cell Lung Cancer using 55Gy in 20 fractions: The North Wales Cancer Centre Experience (ID 2651)

      09:30 - 09:30  |  Author(s): G. Thomas

      • Abstract

      Background
      Hypo fractionated radical radiotherapy using 55 Gy in 20 fractions is one of the most commonly used radical radiotherapy regimens in the UK. The shorter overall treatment time has the radio-biological advantage of minimal re-population. Despite its popularity in UK, there is paucity of supporting data in the reported literature. We present the mature outcome data of this regimen based on the single centre experience in North Wales Cancer Centre,UK.

      Methods
      A retrospective case note analyses of Non-Small-Cell Lung Cancer patients who underwent radical radiotherapy using 55Gy in 20 fraction (fraction size that 2.75 Gy/fraction), between 2001 and 2011, was carried out. We included the patients who had the total dose reduced to 52.5 Gy in 20 fractions to allow for normal tissue constraints. Patients receiving concurrent chemoradiation and adjuvant radiotherapy after surgical resection were excluded. The records were updated using the national registry of death in Wales. Univariate analyses of the effects of different subgroups on overall survival were performed.

      Results

      Table 1. Stage and Histological distribution
      No of patients
      stage IA 27
      IB 35
      IIA 8
      IIB 30
      IIIA 52
      IIIB 66
      IV 1
      Unknown 3
      Histology NOS 37
      Non-Squamous 44
      Squamous 95
      Unknown 46
      Total 222 patients (128 males, 94 females) underwent radical radiotherapy between 2001 and 2011. Median follow up period was 267 weeks (range 74-637). Mean age at diagnosis was 68 yr (41-91). The stage and histological distribution is shown in table 1. Of the stage III patients 81 had induction chemotherapy before the radiotherapy. The median survival of the whole group was 124 weeks (95% CI 105-141) and the survival by histology and stages is shown in table 2. The good 2 yr but poor 5 yr OS of the Stage I patients may reflect their poorer general health at presentation that rendered them medically inoperable. Table 2. Overall survival by Stage and Histological Subgroups
      Median OS in Weeks (95% C.I.) 2 yr OS 5 yr OS
      stage stage 1 135 (116-210) 68% 28% p= 0.47
      stage 2 135 (80-264) 58% 42%
      stage 3 105 (85-141) 50% 27%
      Histology NOS 73 (60-102) 30% 10% p= 0.0004
      Non-Squamous 131 (114-216) 67% 25%
      Squamous 130 (97-162) 57% 35%
      Unknown 191 (131-325) 67% 38%

      Conclusion
      Radical Radiotherapy using 55 Gy in 20 fractions is a highly effective form of treatment for early and locally advanced stages of Non-Small-Cell Lung Cancer with results comparable to isofractionated radiotherapy published in the literature.