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S.Y. Song
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P2.02 - Poster Session/ Treatment of Localized Disease – NSCLC (ID 210)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Localized Disease - NSCLC
- Presentations: 2
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.02-039 - Patterns-Of-Care Study of Stereotactic Ablative Radiotherapy for Lung Cancer in Korea (ID 164)
09:30 - 09:30 | Author(s): S.Y. Song
- Abstract
Background:
Stereotactic ablative radiotherapy (SABR) is an emerging effective technique for early stage lung cancer. We investigated the current practice patterns for stereotactic ablative radiotherapy (SABR) for lung cancer in Korea.
Methods:
A nationwide survey about experience with SABR for lung cancer was sent by e-mail to the radiation oncologists of 85 institutions in May 2014. SABR was defined as hypofractionated radiotherapy (1–8 fractions). The survey contained 23 questions, and those regarding technical details allowed multiple choices.
Results:
Of the 59 institutions that responded to the survey, 33 (56%) had used SABR for lung cancer. Thirty-seven radiation oncologists from these 33 institutions responded to the survey. Seventy-five percent of the oncologists had been treating lung cancer with SABR for less than 5 years, while 89% treat less than 20 cases annually. The most common planning method was rotational intensity-modulated technique (59%), followed by static intensity-modulated technique (49%). A wing board (54%) was most frequently used for immobilization, followed by the vacuum lock system (51%). Respiratory motion was managed by gating (54%) or abdominal compression (51%), and 86% of the planning scans were obtained with 4-dimensional computed tomography. More than half of the respondents (62%) treated daily if a multi-fraction regimen was used.
Conclusion:
The results of our survey indicated that SABR for lung cancer is being used increasingly in Korea, and that the majority of radiation oncologists using this therapy have limited experience in its use. There was wide variation among institutions with regard to the technical protocols, which indicates that standardization is necessary prior to the initiation of further nationwide multi-center, randomized studies.
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P2.02-040 - Clinical Outcome of Fiducial-Less CyberKnife Stereotactic Ablative Body Radiotherapy for Stage I Non-Small Cell Lung Cancer (ID 1221)
09:30 - 09:30 | Author(s): S.Y. Song
- Abstract
Background:
CyberKnife[TM] is a dedicated system for radiosurgery, with a capability of real-time tumor tracking; Synchrony[®] Respiratory tracking system. Xsight[®] lung tracking system with Synchrony[®] Respiratory tracking system make possible direct lung tumor tracking without fiducial markers. However, there was no establised indication of fiducial-less Cyberknife Radiosurgery (CKRS). So, to ascertain whether indication of fiducial-less CKRS can be extended or not , we had evaluated treatment outcome of fiducial-less CKRS using Xsight[®] lung tracking system at AMC and tested accuracy of CyberKnife Xsight[®] lung tracking system without fiducial marker by phantom experiment. Here are the results of fiducial-less CKRS using Xsight[®] lung tracking system for stage I NSCLC.
Methods:
From June 2011 to November 2013, 58 patients received Cyberknife Radiosurgery to lung at Asan medical center. We retrospectively reviewed records of 44 patients of stage I lung cancer exclude 14 patients (6 with Advanced NSCLC, 6 with Rec. lung cancer within 5 years, 2 with lung metastasis from other primary cancer). All analyses were performed using SPSS, version 21.
Results:
Median age at diagnosis was 75 years. Man was 37 (84.1%). Most of patients were inoperable primary lung cancer with poor PFT (mean FEV1: 63.0 % (range 24-138%), mean DLCo : 50.8 % (range 43- 96 %)) or comorbidity or old age. Clinical stage was IA in 30 (68.2 %), IB in 14 (31.8 %) patients. Mean tumor size was 2.6 cm. (1.2 cm-4.8cm, smaller than 2 cm was 12 (27.3%)) Radiation dose were 48 – 60 Gy per 3 - 4 fx. With median follow-up of 23.1 months, there were LR in 3 patients ( 1Y LRFSR : 94.9%, 2Y LRFSR : 90.4% ) and DM in 13 patients (DM only, n= 7). All patients tolerated the radiosurgery well, only 2 patients had grade 3 dyspnea (1 of 2 suffered from ILD aggravation). Most common complication was RT-induced fibrosis & pneumonitis. Eight patients have died due to cancer progression.(1Y OSR : 86%, 2Y OSR : 80.3%)
Conclusion:
Fiducial-less cyberknife radiosurgery showed good local tumor control and survival in medically inoperable stage I NSCLC, which was comparable with that of linac-based stereotactic body radiosurgery or CKRS with fiducial marker. Even though there were some limitations to apply Xsight [®] lung tracking system without fiducial marker, but it could be used safely in relatively small tumor located in not recommended site.
