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S660
ESTRO 36
_______________________________________________________________________________________________
EP-1223 Comparing concurrent versus sequential
chemoradiotherapy in locally advanced NSCLC
G. Wei
1
, G. Xiaobin
1
, G. Xian-Shu
1
, M. Mingwei
1
, C. Ming
1
,
P. Chuan
1
1
Peking University First Hospital, Department of
Radiation Oncology, Beijing, China
Purpose or Objective
The aim of this study was to compare concurrent
(
concurrent arm
)
versus sequential chemotherapy
(
sequential arm
)
with hypofractionated radiotherapy in
the treatment of inoperable locally advanced non-small
cell lung cancer
(
NSCLC
)(
stage
Ⅲ
A or
Ⅲ
B
)
by using
meta-analysis. The primary objective of this study was to
compare the outcomes including tumor response and
overall survival (OS) between sequential arm and
concurrent arm. The secondary objective was to compare
the progression-free survival (PFS) and late adverse event
between the two arms.
Material and Methods
Relevant studies were identified through searching
PubMed, Embase and Web of Science databases till July,
2016. Odds ratio (OR) with 95% confidence interval (CI)
was used as pooled statistics for all analyses.
Results
The analysis was conducted based on the data from 3
studies with 370 patients. The pooled data showed that 3
years OS was not improved in concurrent arm compared to
sequential arm [OR=0.72, 95% CI: 0.42-1.24, P=0.235] .
Whereas the combined results for 1-year OS was OR=1.64,
95% CI
:
1.03-2.61
,
P=0.037. There was no significant
difference of 1- year PFS [OR=1.16, 95% CI
:
0.72-1.84
,
P=0.542] between these arms. Moreover, no significant
difference was found regarding tumor response [OR=1.02,
95% CI
:
0.48-2.19
,
P=0.950] and Grade≥3 late adverse
events [OR=1.42, 95% CI
:
0.77-2.60
,
P=0.261].
Conclusion
Our meta-analysis demonstrated that concurrent arm was
not significantly better than sequential arm in clinical
outcomes.
EP-1224 Therapeutic effects of accelerated
hyperfractionation and conventional fractionation CRT
on NSCLC
T. Mitsuyoshi
1
, Y. Matsuo
1
, T. Shintani
1
, Y. Iizuka
1
, W.A.
Mampuya
1
, H. Nagai
2
, H. Ozasa
2
, Y.H. Kim
2
, T.F. Chen-
Yoshikawa
3
, M. Sonobe
3
, N. Nakajima
4
, A. Yoshizawa
4
, T.
Mizowaki
1
, H. Date
3
, M. Hiraoka
1
1
Kyoto University Hospital, Department of Radiation
Oncology and Image-Applied Therapy, Kyoto, Japan
2
Kyoto University Hospital, Department of Respiratory
Medicine, Kyoto, Japan
3
Kyoto University Hospital, Department of Thoracic
Surgery, Kyoto, Japan
4
Kyoto University Hospital, Department of Diagnostic
Pathology, Kyoto, Japan
Purpose or Objective
Definitive concurrent chemoradiotherapy (CRT) is a
standard treatment for locally advanced non-small-cell
lung cancer (NSCLC); however, no consensus exists
regarding the most therapeutically effective radiotherapy
schedule. In this study, we directly assessed the local and
regional pathological effectiveness of CRT using either
accelerated hyperfractionation (AHF) or conventional
fractionation (CF) by retrospective histopathologic
examination of resection specimens after CRT.
Material and Methods
Data were analyzed from NSCLC patients treated with
induction-concurrent CRT followed by thoracotomy
between October 2006 and June 2015 in our hospital. All
patients received three cycles of induction platinum-
based doublet chemotherapy and concurrent radiotherapy
using either AHF (42 Gy/1.5 Gy bid) or CF (50 Gy/2 Gy qd).
The pathological responses of primary tumor and
metastatic lymph nodes after induction CRT were assessed
using resection specimens. The differences in pathological
responses between the AHF and CF groups were analyzed
using Fisher's exact test.
Results
A total of 51 patients were treated with induction CRT
followed by thoracotomy. There were 39 male (76%) and
12 female (24%), with a median age of 62 (range, 43–78)
years. All patients had a performance status (PS) score
[Eastern Cooperative Oncology Group (ECOG)] of 0. Of the
51 patients, 7 were diagnosed with clinical stage IIB
disease, 34 with clinical stage IIIA disease and 7 with
clinical stage IIIB disease. The histologic subtypes were
adenocarcinoma in 29 patients (59%) and squamous cell
carcinoma (SqCC) in 22 patients (41%). No significant