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P. Antonini
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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)
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P2.05-010 - Stereotactic Radioterapy (SBRT) for Primary and Metastatic Lung Tumors in Elderly Patients (ID 4457)
14:30 - 14:30 | Author(s): P. Antonini
- Abstract
Background:
To evaluate SBRT for primary and metastatic lung tumors in elderly patients.
Methods:
Retrospective analysis of technique and results of SBRT for lung tumors in patients over 75 years old treated in a single institution. Simulation was made with CT, abdominal compression and stereotactic frame. Internal target volume (ITV) was covered according ICRU recommendations. Treatment delivery using planar or noncoplanar fields or VMAT-IMRT dynamic arc. The prescribed dose was either 3 fractions of 15 Gy each or a single 30 Gy fraction. Planar images or cone beam CT were used for verification. Toxicity and radiologic response were assessed using standardized criteria (RTOG and RECIST). Survival rates and toxicities were calculated by the Kaplan-Meier method.
Results:
Between 2002 and 2015, 86 patients had 103 SBRT procedures; of those 66 were for primary lung tumors (T1-2N0M0) and to 37 oligometastases (M1). Median patient age was 80 years (75-88). At the treatment all patients had good performance status (ECOG PS 0-1). The FEV1 was over 30 % of predicted. 10 % of the primary and 67 % of the M1 received systemic treatment before SBRT. 73 % of the patients had 18-FDG PET-CT previous to SBRT. Primary tumors histology included: 48 % epidermoid, 14 % adenocarcinoma, 19 % undifferentiated, 4 % neuroendocrine and 15 % PET positive tumors without histology. In lung M1 patients the origin was in: 53 % NSCLC, 24% colorectal adenocarcinoma, 8.5% urotelial tumors, 8.5% thyroid, 3% endometrial and 3% parotid. Median ITV was 11.6 cm3 (0.9-143). Biological Equivalent Dose BED>100Gy. Transient grade 1 or 2 acute toxicities (cutaneous erythema, esophagitis, rib pain or respiratory symptoms) occurred in 11 %. No grade > 3 acute or any chronic toxicities were identified. Median follow-up 22 months (4-65). Overall survival is 79.4 % at 1 year (78.7 % primary; 81 % M1) and 74.2 % at 2 years (65.9 % primary; 84.6 % M1). Global cancer-specific survival rates were: 80.5 % (78.8 % primary and 84.6 % M1). Local control in the irradiated volume is 97.2% in primary and 100 % in M1 tumors, the only failure was marginal/proximal, in a patient with neuroendocrine histology, rescued with second time SBRT.
Conclusion:
SBRT is an excellent treatment option for lung tumors and metastasis in elderly patients in whom other treatment options might be limited. Our encouraging results are similar or better than those reported for younger patients.
