666 / 1096
S650
ESTRO 36
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those undergoing surgery alone; Group 2, comprising those
undergoing adjuvant chemotherapy (CT) alone; Group 3,
comprising those undergoing adjuvant radiotherapy (RT)
alone; Group 4, comprising those receiving adjuvant
concurrent chemoradiotherapy; and Group 5, comprising
those receiving adjuvant sequential CT and intensity
modulation RT.
Results
We enrolled 588 lung adenoCA (WT EGFR) and squCA
patients without distant metastasis. After adjustments for
age at surgery, surgical years, and Charlson comorbidity
index scores, the multivariate Cox regression analysis
demonstrated that adjusted HRs (aHRs; 95% confidence
intervals [CIs]) for the overall mortality of female lung
adenoCA (WT EGFR) patients were 0.257 (0.111–0.594),
0.530 (0.226–1.243), 0.192 (0.069–0.534), and 0.399
(0.172–0.928) in Groups 2, 3, 4, and 5, respectively. For
male lung squCA patients, the aHRs (95% CIs) for overall
mortality were 0.269 (0.160–0.451), 0.802 (0.458–1.327),
0.597 (0.358–0.998), and 0.456 (0.265–0.783) in Groups 2,
3, 4, and 5, respectively.
Conclusion
Adjuvant CCRT or sequential CT and IMRT ≥5000 cGy
significantly reduced the mortality rate of female lung
adenoCA (WT EGFR) and male squCA pN2 patients.
EP-1200 Early versus late PORT for pathologic stage
IIIA-N2 NSCLC: a multi-institutional retrospective study
M.B. Meng
1
, H.H. Wang
1
, L. Deng
2
, Q.L. Wen
3
, C.Z.
Zhang
4
, X.L. Zeng
1
, Y.L. Cui
5
, Z.Y. Yuan
1
, P. Wang
1
1
Tianjin Medical University Cancer Institute & Hospital,
Department of Radiation Oncology, tianjin, China
2
West China Hospital- West China of Medical School-
Sichuan University, Department of Thoracic Cancer,
Chengdu, China
3
Affiliated Hospital of Southwest Medical University,
Department of Oncology, Luzhou, China
4
Nankai University Tianjin People’s Hospital, Department
of Surgery, Tianjin, China
5
Tianjin Medical University Cancer Institute & Hospital,
Department of Lymphoma, tianjin, China
Purpose or Objective
The aim of this study was to evaluate the effect of the
time of postoperative radiotherapy (PORT) in combined
modality treatment for pathologic stage IIIA-N2 non-small
cell lung cancer (NSCLC).
Material and Methods
Between January 2008 and December 2015, patients with
pathologic stage IIIA-N2 NSCLC were enrolled and treated
with PORT concurrent with or sequential to fewer than
three cycles of postoperative chemotherapy (POCT, early
PORT) or with PORT administered after at least four cycles
of POCT (late PORT) at multiple hospitals. The primary
end point was overall survival (OS); secondary end points
included pattern of the first failure, locoregional
recurrence-free survival (LRRFS), and distant metastasis-
free survival (DMFS). Kaplan–Meier OS, LRRFS, and DMFS
curves were compared with the log-rank test. Cox
regression analysis was used to determine prognosticators
for OS, LRRFS, and DMFS.
Results
Of 112 included patients, 41 (36.61%) and 71 (63.39%)
patients received early PORT and late PORT, respectively.
The median OS, LRRFS, and DMFS were longer for those
who received early PORT than for those who received late
PORT at the median follow-up of 29.6 months (all
p
<
0.05). Uni- and multi-variate analyses showed that number
of POCT cycles and the combination schedule of PORT and
POCT were independent prognostic factors for OS, LRRFS,
and DMFS.
Conclusion
Pathologic stage IIIA-N2 NSCLC patients treated with early
PORT experienced better OS, LRRFS, and DMFS than those
treated with late PORT. Thus, early PORT should be
considered as a primary approach for those patients.
EP-1201 SLR versus SBRT for high-risk elderly patients
with stage I NSCLC
H.H. Wang
1
, M.B. Meng
1
, X.L. Zeng
1
, L. Deng
2
1
Tianjin Medical University Cancer Institute & Hospital,
Department of Radiation Oncology, , China
2
West China Hospital- West China School of Medicine-
Sichuan University, Department of Thoracic Cancer,
Tanjin, China
Purpose or Objective
The purpose of this study was to evaluate the efficacy and
safety of radiotherapy (RT) for high-risk elderly patients
with stage I non-small cell lung cancer (NSCLC) through a
meta-analysis of data from published studies comparing
sublobar resection (SLR) with RT including conventional
fraction radiation therapy (CFRT) and stereotactic body
radiation therapy (SBRT).
Material and Methods
We searched the Cochrane Library, MEDLINE, CENTRAL,
and EMBASE and conducted manual searches. Meta-
analysis was performed on the results of homogeneous
studies. Analyses subdivided by study design were also
performed.
Results
Based on our search criteria, we found 16 trials involving
11540 patients. Nine were propensity-score matched
(PSM) cohort studies, and 7 were cohort studies. Five
studies compared SLR with CFRT, and 11 compared SLR
with SBRT. Our results showed that SLR, compared with
either type of RT, significantly improved the overall
survival regardless in both PSM and non-PSM analyses (all
p
<0.05). However, the pattern of failure after SLR was
similar to that after SBRT (all
p
>0.05). In addition, RT and
SLR were associated with specific complications.
Conclusion
These results demonstrated that SLR treatment of high-
risk elderly patients with stage I NSCLC resulted in better
overall survival compared with RT, including CFRT and
SBRT. Considering the strength of the evidence, additional
randomized controlled trials are needed before each
treatment modality can be recommended routinely.
EP-1202 A lot to a little or a little to a lot - dose-
volume relationships in thoracic tumors
C. Schröder
1
, R. Engenhart-Cabillic
2
, A. Buchali
3
1
Universität Giessen, Klinik für Strahlentherapie und
Radioonkologie- Universitätsklinikum Giessen und
Marburg, Giessen, Germany
2
Universität Marburg, Marburg, Germany
3
Ruppiner Kliniken GmbH, Klinik für Strahlentherapie
und Radioonkologie, Neuruppin, Germany
Purpose or Objective
The purpose of this prospective randomized trial was to
determine which constellation of dose and corresponding
volume of the lung tissue as seen in the dose-volume-
histogram (DVH) - either a lot to a little or a little to a lot
- should be preferred to ensure the best possible outcome
for patients with thoracic carcinomas. To ensure a wider
approach we focused on both objective and subjective
parameters like clinical outcome, changes in pulmonary
function tests (PFT), radiological changes and quality of
life (QoL).
Material and Methods
From 04/12 to 10/15 81 patients with NSCLC, SCLC or
esophageal carcinoma were randomized and treated with
either a 4-field-IMRT (Arm A) or a VMAT (Arm B) technique.