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U. Nestle
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P3.02 - Poster Session/ Treatment of Localized Disease – NSCLC (ID 211)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Localized Disease - NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P3.02-027 - Surgical Salvage Resection for Local Recurrence after Stereotactic Body Radiotherapy for Primary and Metastatic Lung Tumors (ID 2600)
09:30 - 09:30 | Author(s): U. Nestle
- Abstract
Background:
Stereotactic body radiation therapy (SBRT) is an alternative to surgery for the treatment of early stage lung cancer or solitary metastasis in high-risk individuals. The aim of the study was to identify patients that underwent surgical resection as a salvage therapy for local recurrences following SBRT.
Methods:
In a single institution prospective database patients that underwent SBRT for early-stage NSCLC or pulmonary metastatic tumors were identified over 5 years. Patients that underwent surgical salvage resection for local recurrences after SBRT were analyzed for clinicopathological data and outcome.
Results:
In 4/188 (2.1%) patients salvage surgery was performed for local recurrences after SBRT within a median period of 14.5 months. SBRT was performed with a total dosage of 35 Gy in 3 and 37.5 Gy in 1 patient. No perioperative mortality occurred after salvage resection, and complete resection was achieved in all cases. Histopathology demonstrated viable tumor cells accompanied by fibrosis and necrosis in all resected specimens.
Conclusion:
Salvage surgery should be considered in operable patients after lung SBRT for primary and metastatic tumors as viable tumor can be expected. It can be performed safely in appropriate candidates that need to be identified in a multidisciplinary setting. Further analysis of larger series could further clarify true incidence of local recurrences after SBRT and selection criteria for salvage surgery in this challenging group of patients.
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P3.04 - Poster Session/ Biology, Pathology, and Molecular Testing (ID 235)
- Event: WCLC 2015
- Type: Poster
- Track: Biology, Pathology, and Molecular Testing
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P3.04-102 - CC Chemokine Ligand 18 as a Biomarker for the Prediction of Radiation Induced Lung Disease (RILD) (ID 2401)
09:30 - 09:30 | Author(s): U. Nestle
- Abstract
Background:
In patients with fibrosing lung disease the CC Chemokine Ligand 18 (CCL18) is abundantly produced by alveolar macrophages and its concentration is increased in various inflammatory and fibrotic lung diseases. In this study we aimed to analyze the role of CCL18 as a prognostic biomarker for the development of radiation induced lung disease (RILD) after thoracic irradiation.
Methods:
Between August 2011 and February 2012, 60 patients were enrolled prospectively in the study. Forty-six patients were treated for lung cancer, thirteen had an esophageal cancer and one a thymoma. Patients were treated either with conventionally fractionated (n=47) or hypo-fractionated (n=13) radiotherapy. The CCL18 levels in serum were quantified with ELISA (enzyme-linked immunosorbent assay) at predefined time points; before treatment, after 30 Gy, after 60 Gy (for conventional fractionation), at 6 weeks after completion of treatment and 3 months after therapy. These results were then correlated with routinely performed computed tomographies at 6 weeks and 3 months after the last treatment.
Results:
Twenty three patients developed radiologic signs of RILD but only three of them developed symptoms. The mean CCL18 levels, for the whole group of patients, were, before treatment, 110 ng/ml (standard deviation, SD: 53) and at the end of treatment 85 ng/ml (SD: 73). During the first (6 weeks after treatment) and second follow-up (3 months after treatment) the mean CCL18 levels were 93 ng/ml (SD: 57) and 104 ng/ml (SD: 49), respectively. The CCL18 concentrations in serum were not significantly elevated in the group of patients who developed a RILD. The mean CCL18 levels, at six weeks and three months after treatment, were in the RILD-group 94 ng/ml (SD: 62) and 104 ng/ml (SD: 61) and in the non-RILD-group 93 ng/ml (SD: 54) and 103 ng/ml (SD: 39). Furthermore there was no statistical significant correlation between CCL18 levels or decreasing serum CCL18 concentrations and RILD, fibrosis, tumor volume, T-stage, histology, adjuvant therapy, dosimetric parameters such as V20, response after treatment and overall survival.
Conclusion:
These findings do not suggest that the chemokine CCL18 is involved in the development of RILD in patients undergoing radiotherapy for chest tumors.
