Virtual Library
Start Your Search
J. Hoerner-Rieber
Author of
-
+
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)
-
+
P2.05-025 - 9-Year Experience: Prophylactic Cranial Irradiation in Extensive Disease Small-Cell Lung Cancer (ID 4017)
14:30 - 14:30 | Author(s): J. Hoerner-Rieber
- Abstract
Background:
~In 2007, a EORTC study demonstrated a beneficial impact on overall survival with the use of prophylactic cranial irradiation in extensive disease small cell lung cancer. Nevertheless, there is ongoing debate over the role of PCI as patients in this trial did not undergo imaging of the brain prior to treatment, and a recent Japanese randomized trial showed a detrimental effect of PCI on OS in patients with a negative pre-treatment brain MRI. 87% of our patients received brain imaging prior to PCI.~
Methods:
We examined the medical records of 137 patients with extensive disease small cell lung cancer who initially responded to chemotherapy and received PCI between 2007 and 2015. The outcomes, including the development of brain metastases and OS following PCI were analyzed. Survival and correlations were calculated using log-rank, univariate, and multivariate Cox proportional hazards-ratio analyses.
Results:
Median OS after PCI was 12 months and the median nPFS after PCI was 19 months. There was no significant survival difference in patients who received an MRI prior to PCI compared to patients who received a contrast enhanced computer tomography (CT) (p=0.20). Univariate analysis for overall survival did not show a statistically significant effect for known cofactors. Figure 1 Figure: OS (A) and nPFS (B) in patients with ED SCLC treated with PCI. .
Conclusion:
We present the 9-year clinical experience with PCI in ED SCLC patients from one of Europe’s largest Lung Cancer Centres. PCI leads to a nearly doubled median OS compared to the irradiation arm of the EORTC trial with a 2-months prolonged median OS compared to the irradiation arm of the Japanese trial. PCI should remain standard of care for all patients with SCLC who have a response to initial chemotherapy. Contrast enhanced brain MRI instead of CT for staging prior to PCI is recommended if possible.
-
+
P2.05-044 - Influence of Technological Advances and Institutional Experience on Outcome of Stereotactic Body Radiotherapy for Lung Metastases (ID 5675)
14:30 - 14:30 | Author(s): J. Hoerner-Rieber
- Abstract
Background:
Many technological and methodical advances have made stereotactic body radiotherapy (SBRT) more accurate and more efficient during the last years. This study aims to investigate whether technological innovations and experience in SBRT also translated into improved local control (LC) and overall survival (OS).
Methods:
The working group “Stereotactic Radiotherapy” of the German Society for Radiation Oncology established a database of 700 patients treated with SBRT for lung metastases in 20 German centers between 1997 and 2014. It was the aim of this study to analyze the impact of FDG-PET staging (fluoro-deoxy-glucose positron emission tomography), biopsy confirmation, image guidance, immobilization and dose calculation algorithm as well as the influence of SBRT treatment experience on LC and OS.
Results:
Median follow-up time was 14.3 months (range 0-131.9 months) with 2-year LC and OS of 81.2% and 54.4%, respectively. In multivariate analysis, all treatment technologies except FDG-PET staging did not significantly influence outcome. Patients who received pre-SBRT FDG-PET staging showed superior 1- and 2-year OS of 82.7% and 64.8% compared to patients without FDG-PET staging resulting in 1- and 2-year OS rates of 72.8% and 52.6%, respectively (p=0.012). SBRT treatment experience was identified as the main prognostic factor for local control: institutions with higher SBRT experience (patients treated with SBRT within the last 24 months) showed superior LC compared to less experienced centers (p≤0.001). SBRT treatment experience within the last 24 months was independent from known prognostic factors for LC.
Conclusion:
Technological and methodical advancements except FDG-PET staging prior to SBRT did not significantly improve outcome in SBRT for pulmonary metastases. On the contrary, LC was superior with increasing SBRT treatment experience of the individual center.
