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C.E. Abreu
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P2.14 - Radiotherapy (ID 715)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Radiotherapy
- Presentations: 1
- Moderators:
- Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P2.14-003 - Clinical Outcomes of SBRT in Inoperable Elderly Patients with NSCLC: Experience from a Developing Country (ID 8568)
09:30 - 09:30 | Author(s): C.E. Abreu
- Abstract
Background:
Stereotactic body radiation therapy (SBRT) has emerged as a treatment option for patients with early-stage lung cancer, especially in the medically inoperable population. As most reported data are from developed countries, the purpose of this study was to report clinical outcomes and toxicity for SBRT in these patients from a single academic institution from Brazil.
Method:
Between January 2007 and September 2015, 102 consecutives lung lesions at Hospital Sírio–Libanês, São Paulo, were treated with SBRT, of which 59 primary non-small cell lung cancer (NSCLC) (biopsy-proven) lesions from 54 inoperable patients were reviewed from a specific registry (43 lesions were excluded: metastatic or with no biopsy). For patient immobilization, semi-rigid (vaclok based) system was used. The CTV was delineated based on CT data from 3 phases superimposed on 3-dimensional radiation treatment planning systems to obtain an internal target volume (ITV). A median dose of 54Gy (45-60Gy) was prescribed in 3 – 5 fractions per lesion and image guidance was mandatory. Treatment outcomes for in-field local control (LC) per lesions, progression free survival (PFS) and overall survival (OS) were assessed with Kaplan-Meier estimates. Toxicities were graded according to Common Terminology Criteria for Adverse Events version 4.0
Result:
Of the 54 patients analyzed, the majority were elderly (average age 75.7 years; SD ±8.8 years). More than 90% were PET/CT staged with Stage IA 40 (68%) and adenocarcinoma 46 (78,0%) representing the most common stage and histology, respectively. Median follow-up was 21,3 months (4 -55 months) for LC, 22.3 months (4 -55,8 months) for PFS, and 18.7 months (4.2 - 56,4 months) for OS. The 2-year rates of LC, PFS and OS were 89.1%, 79%, and 80.3%. Median LC, PFS, OS was 48.5 months, not reached, 41,8 months, respectively. Histology, size and stage of the primary were not a significant predictor for LC (P = 0.58; P = 0.26; P= 0.64, respectively), PFS (P = 0.81; P = 0.86; P = 0.64, respectively), or OS (P=0.21; P = 0.62; P = 0.94, respectively). Grade 3+ toxicities were observed in 2 patients (3.7%), of which 1 was grade 3 pneumonitis and one was grade 4 skin toxicity.
Conclusion:
Our data also show that SBRT is effective and feasible in a predominantly elderly and medically inoperable patient population in Brazil.
