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M. Nielsen



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    OA 01 - The New Aspect of Radiation Therapy (ID 652)

    • Event: WCLC 2017
    • Type: Oral
    • Track: Radiotherapy
    • Presentations: 1
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      OA 01.02 - Stereotactic Radiotherapy as Salvage Treatment After Surgery and Curative Intended Radiotherapy for Patients with NSCLC (ID 9618)

      11:10 - 11:20  |  Author(s): M. Nielsen

      • Abstract
      • Presentation
      • Slides

      Background:
      Stereotactic radiotherapy (SBRT) is an efficient treatment for early stages of inoperable NSCLC. SBRT may, however, also be used as salvage treatment for recurrent disease. This retrospective study reports and compares the outcome of patients initially treated with surgery and patients initially treated with curative radiotherapy (RT).

      Method:
      All cases of NSCLC treated with RT with curative intent at our institution are prospectively recorded. We here report the results of 114 cases treated at our institution July 2009 to June 2016 with SBRT as salvage therapy. The doses used for peripheral located tumors have been 45-66 Gy (central doses) in 3 fractions (F) while centrally located tumors have been treated with 50-78.4 Gy/ 5-8 F. The patients have been treated with IMRT or VMAT. A group of 80 patients had surgery initially (Surg-Grp): Resection 19 (24%), lobectomy 56 (70%), bi-lobectomy 1 (1%), and pneumonectomy 4 (5%). Another group of 34 patients was initially treated with RT (RT-Grp): SBRT 30 (88%) and conformal chemo-RT 4 (12%). All patients had more than 1 year of potential follow-up.

      Result:

      The patient characteristics
      Surg-Grp RT-Grp p-value
      Age (yr.) 72.6 (55.1; 89.3) 71.7 (53.5; 87.1) 0.56
      Female /Male 45 / 35 18 /16 0.91
      PS 0-1 55 (69%) 15 (44%)
      PS 2 21 (26%) 15 (44%)
      PS 3 4 (5%) 4 (12%)
      Median FEV1 (L/sec) 1.54 (.39-2.72) 1.37 (.42-2.75) 0.59
      Time from initial treatment to salvage treatment (mo) 22.4 (0.6; 272) 20.7 (4.4; 100)
      Salvage RT
      45 Gy/3 F 10 (13%) 9 (26%)
      66 Gy/3 F 54 (68%) 18 (53%)
      50 Gy /5 F 3 (4%) 0
      78.4 Gy /8 F 13 (16%) 7 (21%)
      The median, 1, 2, 3, and 4 year overall survival was 50.5 mo, 85%, 72%, 59%, and 59 % in the Surg-Grp and 31.3 mo., 71%, 55%, 46%, and 46% in the RT-Grp, (p=.13).

      Conclusion:
      SBRT gives excellent survival used as salvage therapy after surgery and curative intended radiotherapy.

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