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S.S. Jeppesen
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P1.02 - Poster Session/ Treatment of Localized Disease – NSCLC (ID 209)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Localized Disease - NSCLC
- Presentations: 2
- Moderators:
- Coordinates: 9/07/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P1.02-038 - A Comparison of Stereotactic Body Radiation Therapy vs. No Treatment for Patients with Early-Stage Non-Small Cell Lung Cancer (ID 1449)
09:30 - 09:30 | Author(s): S.S. Jeppesen
- Abstract
Background:
Scarce information is available concerning the natural history of untreated patients with early-stage Non-Small Cell Lung Cancer (NSCLC). No randomized studies have been conducted comparing Stereotactic Body Radiation Therapy (SBRT) with no treatment for patients with early-stage NSCLC. Previously, it has been suggested that SBRT increases overall survival for patients with NSCLC T1-2N0M0. In this study a national group of untreated patients with early-stage NSCLC was identified in order to compare the effect of SBRT with the natural history in a retrospective setting.
Methods:
From 2007 to 2013, 136 patients diagnosed NSCLC T1-2N0M0 with a tumor diameter up to 5 cm were treated with SBRT at Odense University Hospital. The thoracic RT consisted of 45-66 Gy/3 F delivered in 9 days. For the same period, a national group of 121 untreated patients with early-stage NSCLC was extracted from the Danish Lung Cancer Registry. Of these, 85 patients survived more than one month after the diagnosis was established and might have been candiates to SBRT. Twenty-four patients with unrecorded tumor diameter were excluded from the present analysis thus, 61 patients remained in the untreated group. Pathoanatomical diagnosis was known for all patients. Kaplan-Meier and Cox proportional hazard analyses were used for uni- and multivariable survival analyses, respectively. Overall survival (OS) was calculated from the date of diagnosis.
Results:
The mean age was 72 vs. 78 years in the SBRT and untreated group, respectively. Statistically significant (p<0.05) inter-group differences in patient characteristics were observed for pathological type and FEV1 (%predicted). No difference in gender, tumor size, ECOG performance status, or pack years was observed. The potential median follow-up time was 38 months in the SBRT group vs. 57 months among untreated. A log rank test showed a significant difference of overall survival (OS) between groups e.g. resulting in an OS at 5-year of 44% vs. 10% respectively and a median OS of 47.8 vs. 12.2 months for SBRT and untreated group, respectively (p < 0.01). Multivariate analysis indicated that age, tumor size, pack years, gender, adenocarcinoma and FEV1 (%predicted) had no significant influence on survival, while SBRT and ECOG performance status had (Table 1). Figure 1
Conclusion:
In this study SBRT was associated with significantly longer OS compared to no treatment, suggesting that SBRT is a convenient treatment that increases survival for patients with early-stage NSCLC.
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P1.02-039 - Stereotactic Radiotherapy as Salvage Treatment after Stereotactic Radiotherapy or after Operated Non-Small-Cell Lung Cancer (ID 2240)
09:30 - 09:30 | Author(s): S.S. Jeppesen
- Abstract
Background:
Lobectomy is regarded as the standard of care for early stage non-small-cell lung cancer (NSCLC), but stereotactic radiotherapy (SBRT) is an option for patients who are not candidates for surgery. Although the curative intention treatments, a significant proportion of patients with NSCLC will develop recurrent disease. For patients previously treated with SBRT little is known of retreatment with SBRT in the recurrent setting.
Methods:
All patients with lung cancer treated at our center with SBRT have been registered prospectively. We identified the patients who had salvage SBRT after prior pulmonary surgery or SBRT. Overall survival was calculated from the day of salvage SBRT.
Results:
Between November 2008 and February 2015, 198 patients were treated with SBRT. We identified 24 patients that had received SBRT as salvage treatment for their first recurrence in the lung. Surgery was the initial treatment for 13 of the patients (OP-group) and SBRT was the initial treatment for the remaining 11 patients (RT-group). By the end of follow up, 5 patients in the OP-group had died and 3 in the RT-group. In the OP-group all the salvage SBRT was given as 66 Gy in 3 fractions. In the SB-group, 5 was treated with 56 Gy in 8 fractions, 1 with 45 Gy in 3 fraction and 1 with 45 Gy in 10 fractions when given salvage SBRT.Primary surgery Primary SBRT All Number of patients 13 11 24 Age mean (range) 75 (62-88) 69 (53-87) 72 (53-88) Histology Plano/Adeno/NOS 3/8/2 4/5/2 7/13/4 Time in months from primary treatment to salvage SBRT median (range) 65 (4-236) 17 (5-44) 21 (4-236) Survival time from SBRT 1 year (%) 2 year (%) 85 62 89 61 87 60 Median follow-up months (range) 27.6 (14.3-62.8) 15.9 (1.4-32.9) 21 (1.4-62.9) Lung function FEV1, median (range 1.4 (0.6-2.7) 1.4 (0.4-2.8) 1.4 (0.4-2.8) ECOG Performance Status 0 1 2 3 4 5 3 1 1 2 7 1 5 7 10 2
Conclusion:
Although the time from primary treatment to salvage SBRT was longer if surgery was the primary treatment than if the primary treatment was SBRT, the overall survival was equal for the two groups.
