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A. Toker
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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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P2.14-016 - Pulomonary Resection After Curative Intent Chemoradiation for NSCLC (ID 9623)
09:30 - 09:30 | Author(s): A. Toker
- Abstract
Background:
In this study, we aimed to investigate the validity and clinical outcomes of lung resection after curative intent chemoradiation for locally advanced NSCLC.
Method:
The retrospective review of the prospectively recorded data of patients with NSCLC that was treated with curative intent induction chemoradiation followed by surgery between 1996 and 2016 was carried out. The patients undergoing segmentectomy or bigger resection with lymph node dissection after chemoradiotherapy were included into study. Patients received 2-6 cycles of chemotherapy and 45-70 Gy radiotherapy and were divided into two groups; Group 1: patients who received 60 Gy radiotherapy or less; Group 2: patients who received 61 Gy radiotherapy or more. We compared the chemotherapy drugs, doses, cycles, body mass index and performance status, type of lung resection, 90-day postoperative complications, mortality and long term survival between the two groups.
Result:
One hundred and forty two patients were included into study (group 1 n=88, group 2 n=54). All but 17 patients were male with a mean age of 56.5y (31-85y). Twenty patients underwent pneumonectomy and 122 patients received lobectomy (55 patients with extended resection, chest wall resection and sleeve etc). Complete pathological response was observed in 44(31%) patients (group 1= 29.5% (26/88), group 2= 33.3% (18/54), p=0.63. Postoperative morbidity rate was 42.2% (group 1=47.7% (42/88), group 2=33.3% (18/54), p=0.09. In addition, 90-day mortality rate was 6.3% (group 1=5.6%, group 2=7.4%, p=0.68). The overall survival 5-year survival rate was 54.1% that was 61% in Group 1 and 43.6% in Group 2, respectively (p=0.14). We found no relationships between the radiotherapy dose and the complete response rate, mortality, morbidity and survival.
Conclusion:
These findings reveal that lobectomy or pneumonectomy can be safely performed following high-dose chemoradiotherapy without affecting surgical outcomes. However, the positive or negative effect of high-dose radiotherapy on complete response and survival has not been proven.
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P3.16 - Surgery (ID 732)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Surgery
- Presentations: 1
- Moderators:
- Coordinates: 10/18/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P3.16-046 - Pneumonectomy After Induction/Neoadjuvant Treatment for NSCLC: Morbidity, Mortality and Long-Term Survival (ID 9562)
09:30 - 09:30 | Author(s): A. Toker
- Abstract
Background:
To compare the effects of neoadjuvant/induction chemotherapy or chemoradiation on morbidity, mortality, and long-term survival in patients with locally advanced NSCLC undergoing pneumonectomy.
Method:
All pneumonectomies following neoadjuvant treatment performed for NSCLC between 2000 and 2016 were retrospectively reviewed. The study included 162 patients (28 females; median patient age, 55.4 years [range, 31–73]). Neoadjuvant treatment consisted of chemotherapy in 115 patients (71%, group I) and chemoradiation in 47 patients (29%, group II). Chemotherapy was cisplatin-based, and 2–6 cycles of treatment were completed. Radiotherapy was administered sequentially (dose, 45–60 Gy). Surgery was performed 3–6 weeks after neoadjuvant treatment. Both groups were assessed for 90-day mortality, morbidity, and long-term survival.
Result:
Right pneumonectomy was performed in 60 (37%) patients, and the procedure was completed in a standard manner in 64.2% of the patients. Morbidity was observed in 27.7% of the patients (27,8% in group I; 27.6% in group II,p=0.98). The incidence of bronchopleural fistula was 4.3% (4.2% in group I; 4.3% group II). The 90-days mortality rate was 3.1% (5 patients in group I, 0 in group II,p=0.17). The mortality rates for right and left pneumonectomy were 3.3 (2/60 patients) and 3% (3/102 patients), respectively (p=0.61). The 5-year survival rates were 46.2% in group I and 54.2% in group II, (P = 0.16).
Conclusion:
Pneumonectomy after neoadjuvant chemotherapy or chemoradiation appears to be safe with an acceptable morbidity, mortality, and long-term survival. Chemoradiation did not improve long-term survival compared to chemotherapy despite comparable 90-day mortality and postoperative morbidity.
