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)

  • 17838

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    P2.05-055 - 90 Day Mortality and Survival Following Radical Radiotherapy for Non-Small Cell Lung Cancer Treated in the Dorset Cancer Centre, UK (ID 5381)

    14:30 - 14:30  |  Author(s): M. Roberts
    • Abstract

    Background:
    The prognosis from non-surgical treatment of non- small cell lung cancer remains poor. Patients are often elderly with multiple comorbidities. Evaluating toxicity and patient outcomes is essential to guide appropriate patient selection for intensive treatment. In addition to overall survival (OS) and progression free survival (PFS), 90 day mortality is increasingly recognised as a metric of service quality in the delivery of radiotherapy and reporting is recommended by the National cancer reform Strategy UK 2011.
    
    Methods:
    Consecutive patients were included who commenced radical radiotherapy between January 2013 and December 2015. 90 day mortality was calculated from the last day of radiotherapy to the date of death. PFS and OS were estimated from Kaplan-Meier curves. Patients who developed a recurrence were reviewed to determine if this was within the radiotherapy field.
    
    Results:
    115 patients were included. The median age was 70 (range 43-96), recent trials such as RTOG 9410 have an age limit of 75-79. Median follow-up was 14 months (range 1-38). The majority (61.7%) were stage III. 57.4% were ex-smokers, 41.7% were performance status 1 and 86% had a co-morbidity score of 1 or above (ACE27). 45.2% received radiotherapy alone, the remaining received concurrent chemo-radiotherapy . 7 patients (6%) died within 90 days. The 1 year PFS and OS were 70% and 81% respectively. Of the 49 recurrences, 26 (22.6%) were within the radiotherapy field. There was a correlation between a high V20 figure (volume of lung receiving 20Gy) and worsening survival (p=0.0218), measured by cox proportional hazard model.
    
    Conclusion:
    The 90 day mortality is 6% in this series of unselected relatively elderly patients, likely to be representative of the population of patients presenting to clinical oncologists in many cancer centres in the UK. This is comparable to the recent series reported by the Christie hospital and helps build a bench mark for comparison. Further work to identify factors increasing the risk of early death and strategies to identify and proactively manage toxicity and comorbidities during and immediately after treatment are required. Patient selection for concurrent chemotherapy is challenging in the very elderly or those with multiple comorbidities and may have had an impact on our outcomes. The in-field recurrence rate of 22.6% emphasizes the need to improve radiotherapy delivery and support the need for further clinical trials in this area looking at acceptable methods of safe dose escalation, such as the soon to open ADSCAN trial.