Author of

• 17783

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  P2.05 - Poster Session with Presenters Present (ID 463)

  • Event: WCLC 2016
  • Type: Poster Presenters Present
  • Track: Radiotherapy
  • Presentations: 1
  • Moderators:
  • Coordinates: 12/06/2016, 14:30 - 15:45, Hall B (Poster Area)

  • 17792

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    P2.05-009 - The Outcome and Adverse Event of Chemoradiation ± Surgery for Stage III Non-Small Cell Lung Cancer (ID 4425)

    14:30 - 14:30  |  Author(s): Y. Okubo
    • Abstract

    Background:
    Concurrent chemoradiation therapy (CRT) is standard for stage III non-small cell lung cancer (NSCLC). In our institute, patients undergo surgery after CRT if possible. We aimed to assess the efficacy and adverse event of CRT in patients with stage III NSCLC and investigate the risk of radiation pneumonitis (RP).
    
    Methods:
    Two hundred fifty seven patients received CRT for newly diagnosed stage III NSCLC from 2003 to 2013. Patient characteristics were as follows: 87.2 % male; median age, 67 years; 55.6 % stage IIIA; and 44.4 % IIIB. CRT was prescribed, with 40Gy to the primary tumor and mediastinum and a boost of 20Gy to all gross disease. All patients also received platinum based doublet regimen concurrently. After CRT, the patients were re-evaluated in the resectability and underwent surgery. We analyzed tumor volume reduction ratio near the end of radiation therapy. All patients were classified by their lung condition about emphysematous and interstitial changes with CT images before treatment into three degree (slight / moderate / severe). Patients with grade 2 or worse RP were ebaluated with their Dose-Volume Histofram(DVH) parameteres of both lungs.
    
    Results:
    The median follow up time was 73.9 months. The 3-year and 5-year overall survival rates were 44.8 % and 33.0 % in all patients, and 74.7 % and 64.7 % in patients with CRT followed by surgery. The 3-year and 5-year local control rates were 68.8 % and 49.0 %, respectively, in all patients. More than 50 % volume reduction was observed in 73.2 % of patients surviving over 2-years, but 32.3 % of these good responder had local failure. Grade 2 or worse RP were observed in 70 patients (27 %), grade3 in 11 patients (4 %), grade 5 in 3 patients (1 %). The median of V5Gy, V10Gy, V20Gy, V40Gy, and mean dose of group with grade 2 or worse RP were 32.1, 27.5, 22.5, 16.5 %, and 13.5Gy, respectively, and with grade 3 to 5 RP were 31.5, 27.9, 23.9, 19.0 %, and 12.8Gy, respectively. In patients with grade 3 to 5 RP, 8 of 14 patients had severe emphysematous lung and moderate or severe interstitial change, or had over 30 % lung V20Gy.
    
    Conclusion:
    CRT for stage III NSCLC was effective with acceptable toxicities. Even though patients had good early response to CRT, local control was not sufficient. Grade 3 or worse RP may relate not only to DVH parameters, but also pulmonary complication before CRT.