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)

  • 17809

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    P2.05-026 - Postoperative Radiotherapy in Non-Small Cell Lung Cancer: 20 Years' Experience in a Single Centre (ID 6393)

    14:30 - 14:30  |  Author(s): O. Karakoyun-Celik
    • Abstract

    Background:
    The purpose of this study is to evaluate the long term outcomes of postoperative radiotherapy(PORT) in patients with NSCLC.
    
    Methods:
    A total of 130 patients with resected NSCLC who were treated with PORT between January 1994 and December 2014 were respectively evaluated. Among the whole group 86 patients(66%) were treated with Co60 machines till 2005, and 44 patients(34%) with 6-10 MV photons with linear accelerators. Median RT dose was 54 Gy(range, 48-66 Gy) with 2 Gy daily fractions. the treatment fileds covered the bronchial stump, ipsilateral hilum and mediastinum in 109patients(83.8%);bronchial stump,ipsilateral hilum, mediastinum and supraclavicular nodes in 15patients(11.5%);and bronchial stump and ipsilateral hilum in 6patients(4.6%).Cisplatinum-based chemotherapy was administered to 69(53%) patients. Chemoterapy was applied preoperatively in22 patients(17%), concomitantly in 27 patients(21%), and after PORT in 20patients(15%). Overall(OA) survival, locoregional-free(LRF) survival and distant-metastasis free(DMF) survival were calculated using the Kaplan-Meier method.
    
    Results:
    The median age of the patients was 59 years (range,35-75 years). The most frequently performed surgical procedure was lobectomy (64.6%), followed by pneumonectomy(19.2%), wedge resection (10%), and bilobectomy(6.2%). Stages included I(19.2%), II(42.3%), IIIA (30.8%), and IIIB(6,9%).Neoadjuvant chemotherapy was applied to 62% of stage III patients.The median overall survival was 48 months. The 5-year OA, LRF and DMF survival rates for whole group were 43%, 75%, and 63% respectively.Significant prognostic factors for OA survival were indicated in the table. Acute and subacute toxicities were Grade I to II esophagitis in 48 patients (37%), anemia in 11 patients(8%), pulmonary infection in 11 patients (8%),and Grade ≥II radiation pneumonitis in 11 patients(8%) Radiation-induced late toxicities including radiologic Grade I to II fibrosis were recorded in 22 patients (17%).

    The Prognostic Factors for Overall Survival

    Characteristics	5-yearOA survival	UnivariateAnalysis (Log-rank p value)	Multivariate Analysis(Cox regression p value)
    Age(Years) <59 >=59	55 32	0.012	0.000
    KPS 70-80 90-100	35 48	0.028	0.003
    Laterality Left Right	31 54	0.011	0.005
    Stage T1-T2 T3-T4	55 28	0.001	0.050
    Dose <54 >=54	55 36	0.037	0.006

    
    
    Conclusion:
    Unfavorable prognostic factors for PORT were RT dose > 54 Gy, advanced T stage, poor Karnofsky performance status, advanced age, and left sided tumors. When irradiating left-sided tumors cardiac toxicity must be kept in mind.