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N. Nakamura
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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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P2.05-005 - Proton Beam Therapy for Early Stage Lung Cancer: A Multi-Institutional Retrospective Study in Japan (ID 9142)
09:30 - 09:30 | Author(s): N. Nakamura
- Abstract
Background:
The purpose of this study to evaluate the clinical outcome of proton beam therapy (PBT) for early stage lung cancer or small lung lesions clinically diagnosed as primary lung cancer in Japan.
Method:
Between April 2004 and December 2013, 669 patients with 682 tumors with histologically or clinically diagnosed Stage I non-small cell lung cancer (NSCLC) according to the 7th edition of UICC were treated with PBT. The medical record and imaging studies were retrospectively reviewed to analyze survivals, local control, and toxicities.
Result:
Four hundred eighty-six (72.6%) of 669 patients were men, with the median age of 76 years (range, 42 – 94 years). Tumors were distributed according to T-stage as follows: T1a (265 tumors, 38.9%), T1b (216 tumors, 31.7%), and T2a (201 tumors, 29.4%). Tumors were distributed according to histology as follows: squamous cell carcinoma (139 tumors, 20.4%), adenocarcinoma (277 tumors, 40.6%), others (32 tumors, 4.7%), and not proven (234 tumors, 34.3%). As for operability, 351 patients were found to be operable, 294 were inoperable, and 24 patients were unknown for operability. The median biological effective dose (BED) of PBT was 109.6 Gy RBE (range, 74.4 – 131.3 Gy RBE). The median follow-up time was 38.2 months (range, 0.6 – 154.5 months) for all patients. The 3-year overall survival (OS), progression-free survival (PFS), and local control were 79.5%, 64.1%, and 89.8%, respectively. Radiation pneumonitis ≥ Grade 3 according to CTCAE v3.0 was observed in 12 (1.8%) patients. The 3-year OS and PFS for 440 patients with histologically confirmed NSCLC were 78.0% (80.7% for IA, 73.0% for IB, p = 0.042) and 66.4% (71.9% for IA, 55.9% for IB, p = 0.0038), respectively. The 3-year OS and PFS for 229 patients with clinically diagnosed NSCLC were 82.4% (86.0% for IA, 60.4% for IB, p = 0.045) and 69.6% (74.0% for IA, 42.6% for IB, p = 0.0052), respectively. The 3-year OS and PFS for 351 operable patients were 86.7% (88.8% for IA, 80.3% for IB, p = 0.096) and 70.6% (76.4% for IA, 52.8% for IB, p = 0.0028), respectively. The 3-year OS and PFS for 294 inoperable patients were 70.5% (74.1% for IA, 62.8% for IB, p = 0.046) and 56.6% (62.6% for IA, 44.6% for IB, p = 0.0062), respectively.
Conclusion:
PBT for early stage lung cancer is an effective treatment option with low incidence of severe radiation pneumonitis.
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P3.14 - Radiotherapy (ID 730)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Radiotherapy
- Presentations: 1
- Moderators:
- Coordinates: 10/18/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P3.14-001 - Impact of PCI on Prognosis of LD-SCLC Through Pattern of Brain Metastases as a First Recurrence Site (ID 9648)
09:30 - 09:30 | Author(s): N. Nakamura
- Abstract
Background:
Brain metastases frequently occur in patients with small-cell lung cancer. Therefore, prophylactic cranial irradiation (PCI) is recommended for good responders of initial treatment. The purpose of this study was to investigate influence of PCI on pattern of brain metastases as a first recurrence site (BMFR) after radical treatment for limited disease small-cell lung cancer (LD-SCLC).
Method:
This retrospective study included LD-SCLC patients treated with thoracic radiotherapy and concurrent chemotherapy between January 2006 and December 2014. Induction chemotherapy was permitted. Thoracic radiotherapy was performed with accelerated hyper-fractionated radiotherapy (twice daily, 45 Gy in 30 fractions over 3 weeks) or conventional-fractionated radiotherapy (once daily, 50 Gy in 25 fractions over 5 weeks). Regimen of chemotherapy consisted of intravenous platinum-etoposide.
Result:
One hundred and sixty-two patients were included in this study. The median follow-up duration for surviving patients was 38 months (range, 6-105 months). Among 123 patients (76%) who died, 104 patients died due to disease progression, 11 died due to unknown cause and 8 died due to other cause. Ninety-three patients (57%) underwent PCI, and the 3-year disease specific survival (DSS) rates were 20%(12-35) in patients without PCI and 43%(33-55) in those with PCI (p<0.001). Concerning the recurrence pattern, the frequency of BMFR was significantly higher in patients who did not underwent PCI compared with those who did (49% vs 25%, p=0.008) although no significant difference in frequency of all site of recurrence was observed between patients without PCI and those with PCI (83% vs 73%, p=0.109). Regarding the impact of BMFR on prognosis, patients with BMFR exhibited significant shorter DSS than those whose first recurrence sites was other than brain metastases (3yr-DSS 6% vs 22%, p=0.007), and patients who developed BMFR without PCI exhibited significant lower DSS compared with those who developed BMFR with PCI (3yr-DSS 0% vs 17%, p=0.005). In addition, 68% of patients who did not underwent PCI exhibited multiple BMFR lesions with 5 or more while 12% of patients who did (p<0.001).
Conclusion:
The results of this study indicated that BMFR exhibited significant negative impact on prognosis after radical treatment for LD-SCLC and the difference in the number of metastatic lesions in BMFR between patients with PCI and those without PCI might affect clinical outcomes.