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J. Li
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MA05 - Innovative Techniques in Pulmonology and the Impact on Lung Cancer (ID 378)
- Event: WCLC 2016
- Type: Mini Oral Session
- Track: Pulmonology
- Presentations: 1
- Moderators:J. Eckmayr, P.R. Mohapatra
- Coordinates: 12/05/2016, 16:00 - 17:30, Strauss 1
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MA05.09 - There is a Closely Relation between Exhaled Nitric Oxide and Radiation Pneumonitis (ID 5977)
17:00 - 17:06 | Author(s): J. Li
- Abstract
- Presentation
Background:
Radiation pneumonitis is a major toxicity after the thoracic radiotherapy, with no method available to accurately predict the individual risk. This was a prospective study to evaluate the exhaled nitric oxide as a predictive biomarker for radiation pneumonitis in the patients received the thoracic radiotherapy
Methods:
A total of 68 patients with lung cancer or esophageal cancer, who received the thoracic radiotherapy, were enrolled in the present study. Each patients underwent the exhaled nitric oxide measurement before the radiotherapy and at the end of radiotherapy. Pneumonitis toxicity was scored using the Common Terminology Criter
Results:
Of the 68 patients, 65 were evaluable. The pneumonitis toxicity grade were grade 3 for 6, grade 2 for 11 and grade0-1 for48. The exhaled NO measured before radiotherapy and at the end of radiotherapy were 23.05±9.59 (range 10-53) and 22.89±8.60(range 11-60) ppbs.For the exhaled NO ratio, the AUC is 0.879 (95%CI0.774-0.984). The accuracy of predicting the symptomatic patients was identified “good” according to the predictive ability criteria and the optimal cutoff value was tested as 1.305. For the exhaled at the end of RT, the AUC is 0.774 (95%CI 0.656-0.892). The accuracy of predictive the symptomatic patients was evaluated “fair” ,The optimal cutoff value was identified 19.5 ppbs.
Conclusion:
The exhaled nitric oxide ratio>1.305 or the exhaled nitric oxide at the end of radiotherapy>19.5ppbs was found to have a closely relation with radiation pneumonitis.
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P2.05 - Poster Session with Presenters Present (ID 463)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Radiotherapy
- Presentations: 2
- Moderators:
- Coordinates: 12/06/2016, 14:30 - 15:45, Hall B (Poster Area)
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P2.05-031 - The Clinical Impact of Different Chemotherapy Regimen Combined with Radiotherapy in Locally Advanced Non-Small Cell Lung Cancer (ID 5967)
14:30 - 14:30 | Author(s): J. Li
- Abstract
Background:
Different chemotherapy regimen have different toxicity for lung. which regimen can improve the therapeutic effect and reduce the toxicity reaction have not reached a consensus. This was a retrospective study to evaluate the clinical toxicity reaction and therapeutic of different chemotherapy regimen combined with radiotherapy for the treatment of locally advanced non-small cell lung cancer (NSCLC).
Methods:
117 non-small cell lung cancer patients were randomly dividedinto 3 groups,(1) group A( the patients received concurrent chemotherapy consisting of gemcitabine /cisplatin combined with radiotherapy), (2)group B (the patients received concurrent chemotherapy consisting of paclitaxel /cisplatin combined with radiotherapy) and (3) group 3( the patients received the concurrent chemotherapy consisting of Changchun vinorelbine, irinotecan, pemetrexed or other chemotherapeuticdrugs/cisplatin combined with radiotherapy). All the patients received 2-4 cycles chemotherapy, and 2-2.2 Gy per fraction to a total of DT56-66 Gy thoracic radiotherapy 5 times per week.
Results:
The overall response rate (CR+PR) of the three group was86.7%, 78.7%, 81.5% (x[2]=1.626, P=0.653). The 1-year, 2-year and 3-year progressionfree survival ratesof the three group were: 57.3%, 30.1%, 18.3%; 49%, 33.3%, 18.4% and 39.2%, 27.8%, 16.5% (x2=0.581，P=0.748). The 1-year, 2-year and 3-year overallsurvival rates were 89.3%, 48.5%, 30.3%; 65.5%, 43.3%, 26.8% and 70.3%, 48.3%, 31.6% (x2=1.658，P=0.437). The 1-year, 2-year and 3-year distant metastasis rates were 68%, 38.2%, 21%; 50.3%, 35.3%, 28.1% and 56%, 35.3%, 29.6% (x2=0.559，P=0.756).The incidence of radiation pneumonitis of the 3 group were: 37.5%、24%、20%(x[2]=4.909，P=0.037). In addition, the incidence of radiation esophagitis and bone marrow suppression in the three groups were 26.7%, 18.7%, 14.8 (P=0.832) and 26.7, 50.6%, 33.3%, (P=0.024).
Conclusion:
The patients received concurrent chemotherapy consisting of gemcitabine /cisplatin combined with radiotherapycould significantly increase the incidence of radiation pneumonitis, the patients received concurrent chemotherapy consisting of paclitaxel /cisplatin combined with radiotherapyalso had a high incidence of radiation pneumonitis. The local control rate and survival rate of the three groups were not statistically different .
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P2.05-046 - Is Delineating Clinical Target Volume a Must for Medium and Late Stages of Non-Small Cell Lung Cancer? (ID 5940)
14:30 - 14:30 | Author(s): J. Li
- Abstract
Background:
The main reason for a low progression-free survival rate in radiotherapy for NSCLC is that the lung is sensitive to radiation, and radiation-induced lung injury is closely related to the exposed volume of the lung tissues. A large irradiation field resulted in difficulty in increasing target dose, so clinically complete remission is very difficult in the primary lesion of the lung cancer. Therefore, as opinions are currently divided on whether it is necessary to delineate the CTV, this study aimed to study the impact of delineating CTV on the treatment of lung cancer.
Methods:
A total of 177 patients with medium and late stages of NSCLC diagnosed by pathology and/or cytology were selected. These patients received three-dimensional conformal radiation therapy (3-DCRT) or intensity modulated radiation therapy (IMRT) were divided into an undelineated CTV group (A group) and delineated CTV group (B group). Gross tumor volume (GTV) and planning target volume (PTV) were delineated in the A group, while CTV was additionally delineated in the B group. Dose was fractionated in pulmonary lesions in the two groups: 200-220 cGy/time, 5 times per week, and the radiation dose was DT5600- 6600 cGy.The mean lung tumor doses were comparable between the two groups.
Results:
The short-term overall response rate had a trend to be higher in group B, while the 1-year, 2-year and 3-year distant metastasis rates, progression-free survival and overall survival rates had a trend to be higher in group A, but none of the differences were significant. The incidence of radiation pneumonitis was higher in group B (33.33% vs. 16.30%, P=0.017), but none were Grade-4 or worse.
Conclusion:
Undelineating the CTV in radiotherapy of lung tumors tends to reduce the radiation field and significantly reduce the incidence of radiation pneumonitis, but it don’t reduce overall response rate, the progression-free survival and overall survival rate.
