Year: 2017
Type: conference-abstract
Abstract: Material and MethodsWe retrospectively analyzed outcomes in patients with a primary or recurrent non-small cell lung cancer measuring ≥5 cm, who were treated with 5 or 8 fractions of SABR at a single center, between 2003-2014.Patients who had prior thoracic radiotherapy were excluded.The maximum tumor diameter in the axial, transversal, or sagittal planes was measured on lung window-level settings in the endinspiratory phase of the 10-phase free-breathing fourdimensional planning CT scan.Between 2003-2008, SABR was delivered using 8-12 non-coplanar static conformal beams and stereoscopic X-ray image-guidance, and after 2008, Volumetric Modulated Arc Therapy was used with online cone-beam CT based positioning on the tumor.All cases with potential severe toxicity (i.e.grade 3 or higher, ≥G3) were evaluated by a clinical panel consisting of three clinicians using the Common Terminology Criteria for Adverse Events version 4.03, and was consensus based.Results 63 consecutive patients with a median tumor diameter of 5.8 cm (range 5.1-10.4)were identified; 81% had T2N0 disease, and 18% T3N0.Median Charlson Comorbidity Index was 2 (range 0-6).After a median follow-up of 54.7 months, median survival was 28.3 months (95% CI 18.3-38.2).For T2b tumors, median OS was 28.7 months (95% CI 12.2-45.3),and for T3 tumors this was 21.5 months (95% CI 16.4-26.6).Disease free survival at 2 years was 82.1%, and local, regional, and distant control rates at 2 years were 95.8%, 93.7%, and 83.6%, respectively.Distant metastases only were the commonest pattern of failure (10%).≥G3 toxicity was recorded in 30% of patients, with radiation pneumonitis the most common toxicity (19%).A likely (n = 4) or possible (n = 8) treatment-related death was scored in 19% of patients.Retrospective review of CT scans revealed pre-existing interstitial lung disease in 8 patients (13%), with fatal toxicity developing in 5 of them (63%). ConclusionLung SABR in tumors ≥5 cm resulted in high local control rates and acceptable survival outcomes, except in patients with co-existing interstitial lung disease.Our findings indicate that a more systematic screening for interstitial lung disease should take place prior to referral for SABR.
Source: Radiotherapy and Oncology
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,770
OpenAlex ID: W2734682508