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Lim Mei Ying
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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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P2.05-008 - Stereotactic Body Radiotherapy (SBRT) for Early Stage I Lung Cancer: A Review from an Oncology Center in Hong Kong (ID 10552)
09:30 - 09:30 | Presenting Author(s): Lim Mei Ying
- Abstract
Background:
Traditionally, patients with medically inoperable early stage non-small-cell lung cancer (NSCLC) were treated with conventional radiotherapy of 60 Gray (Gy) over 6 weeks. comparable results as surgery. Primary objective of this review was to evaluate the clinical outcomes of stage I NSCLC patients after SBRT, including 1-year, 3-year and 5-year local control, overall survival and cancer-specific survival rates. Secondary objectives were acute and late toxicities.
Method:
Patients with stage I NSCLC (tumor size ≤5cm), ECOG performance status ≤2, who were not surgical candidates (either inoperable or patient refusal) were treated by SBRT in our hospital since 2012. Tumor motions with respiratory cycles were accounted for by using four-dimensional computerized tomography. A margin of 5mm (1cm superior-inferior) was used to generate the planning target volume. A total dose of 50 or 60 Gy in 5 fractions over 2 weeks was given, depending on the location of tumors. Survival plots were produced by Kaplan-Meier estimate.
Result:
A total of 40 patients were included (male=23, 57.5%; female=17, 42.5%). Median age was 75 (range: 42-85). Half (n=20) of patients had stage Ia disease. Median gross tumor volume and planning target volume were 15.80cm3 (range:2.80-56.80cm3) and 47.6cm3 (range:12.50-117.70cm3) respectively. No concomitant systemic therapies were used. After a median follow-up of 23.6 months (range:3.5-68.6 months), twelve patients died (4 were non-cancer related). Median overall survival (OS) was 35.5 months (range:3.5-68.6 months). The 1-year, 3-year and 5-year OS was 92.4%, 48.2% and 37.2, while the cancer-specific survival was 94.7%, 53% and 40.9% respectively. Nine (22.5%) had local progressions, giving rise to the 1-year and 5-year local control rate of 87.2% and 75.3%. Acute and late toxicities occurred in 35% (n=14) and 17.5% (n=7) of patients but all are grade 1 only.
Conclusion:
SBRT in early stage I NSCLC achieves high local control rate and overall survival comparable to radical surgery. Comparing to conventional radiotherapy, SBRT is better tolerated and reduces the treatment period from 6 to 2 weeks. SBRT should be the preferred treatment for early stage NSCLC when radical surgery is not to be considered.
