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Yuho Maki
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P2.05 - Early Stage NSCLC (ID 706)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Early Stage NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P2.05-009 - Outcome of Stereotactic Body Radiotherapy for Clinical Stage I Non Small Cell Lung Cancer and CT Findings: Comparison with Surgical Resection (ID 9964)
09:30 - 09:30 | Presenting Author(s): Yuho Maki
- Abstract
Background:
The standard care for Stage I non small cell lung cancer (NSCLC) is surgical resection, but stereotactic body radiotherapy (SBRT) can be an alternative treatment option, especially for patients with comorbidities. However, it is difficult to compare the outcomes of SBRT with surgical resection because their characteristics are so different, and the risk factors for recurrence after SBRT are not fully understood. In this study, we report pretreatment clinical characteristics and CT findings in patients treated with SBRT, and reviewed patients underwent surgery with similar tumors.
Method:
Between January 2012 and December 2015, patients treated with SBRT for cT1-2N0M0 NSCLC and 218 patients who underwent surgery for cT1b-2N0M0 NSCLC in our institution were analyzed.
Result:
During the study period, 88 patients were treated with SBRT. The 3-year disease free survival (3-year DFS) for all patients was 81.2%. There were 15 cases of recurrences (9 cases of lymph node recurrences, 8 cases of distant metastases and 2 cases of local recurrence. 4 cases were both lymph node and distant metastases). There was no recurrence among the patients with no more than 1cm of consolidation (cT1a or less according to the 8th edition of the Union for International Cancer Control TNM classification) and all recurrent cases were with solid pattern predominant tumors (maximum consolidation diameters were more than 50% of tumor diameters) based on CT findings. Then we evaluated outcomes and clinical characteristics of patients who were treated with SBRT or underwent surgery for cStage I, cT1b or more and solid predominant NSCLC during the same period. 61 patients were treated with SBRT and 218 underwent surgery (190 cases of lobectomy, 21 secmentectomy and 7 wedge resection). Among clinical characteristics, smaller tumor sizes tend to be treated with SBRT (average sizes were 2.25 and 2.57 cm respectively, p=0.055). The mean age was significantly higher in SBRT group (78.5 vs 68.0, p<0.001). Surgical resection was associated with improved DFS (3-year DFS 84.4% vs 73.4%, p=0.004) and lymph node metastasis was found in 34 cases (15.6%) pathologically in patients underwent surgery, suggesting they are incurable with SBRT.
Conclusion:
The main limitations of this study are the small number of cases and different patient characteristics. Taken together, our data suggesting SBRT is acceptable for patients with cT1a or less, cStage I NSCLC, and surgical resection is recommended for patients with more advanced NSCLC.
