ESTRO 36 Abstract Book

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S652 ESTRO 36 2017
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Results
Increased levels of CEA, SCC, Cyfra 21-1, and NSE levels
were detected in 52 (29%), 32 (18%), 61 (34%), and 81
(45%) patients, respectively. According to the histologic
subgroup, patients with adenocarcinoma presented
significantly higher levels of CEA at baseline than those
with other histology. Significantly increased levels of SCC
and Cyfra 21-1 at baseline were present in squamous cell
carcinoma. Proportion of patients with increased NSE at
baseline was higher in small cell carcinoma than other
histology. For the group of 105 NSCLC patients, the median
survival was 7 months for patients with increased post-
CCRT NSE and 26 months for patients with normal post-
CCRT NSE (p=0.002). For the group of 74 small cell
carcinoma patients, the median survival was 7 months for
patients with increased pre-CCRT NSE and 27 months for
patients with normal pre-CCRT NSE (p<0.001). In the
multivariate analysis, high level of NSE, histology, and
tumor diameter were significantly correlated with worse
survival.
Conclusion
These findings suggest that pre- and post-CCRT NSE levels
exhibit prognostic values in patients with lung cancer
undergoing definitive CCRT. The combined use of serum
NSE may provide additional information for prognosis.
EP-1219 Concomitant radiotherapy and TKI in EGFR
mutant or ALK positive stage IV non-small cell lung
cancer
P. Borghetti1, M. Bonù2, E. Roca 3, E. Salah2, A. Baiguini2,
S. Pedretti1, M. Maddalo1, M. Buglione2, S. Magrini2
1 Spedali Civili di Brescia, Radiation Oncology, Brescia,
Italy
2 Brescia University, Radiation Oncology, Brescia, Italy
3 Spedali Civili di Brescia, Medical Oncology, Brescia,
Italy
Purpose or Objective
To investigate the role of radiotherapy (RT) in the
management of EGFR-mutant or ALK positive metastatic
non-small cell lung cancer (NSCLC) treated with TKI at
onset or after standard chemotherapy
Material and Methods
Clinical data of 50 patients (pts) treated with RT
concomitant to TKI for EGFR-mutant or ALK positive NSCLC
stage IV were revised. Overall survival (OS) and toxicities
were analysed as endpoint of the study. Kaplan-Meyer
curve and log-rank test were elaborated for analysis of
survival, while chi-square test was calculated to compare
different variables.
Results
A description of the series is reported in Table 1. Median
age of pts was 65 years. Biological targeted therapy for
EGFR-mutant and ALK positive metastatic NSCLC was used
in 82% and 18% of cases. Three pts were submitted to 2
TKI. Stereotactic radiotherapy was performed in 9 pts, 8
of them were treated for oligoprogressive disease and 1
for palliation (p 0.00). RT was performed within 30 days
before TKI, concomitant to TKI and within 30 days after
TKI in 8, 33 and 9 cases. Median duration of biological
targeted therapy in the whole series was 11.9 (0.4-59.1)
months, while was of 9.7 (0.4-33.5), 14.2 (1.7-59.1) and
8.3 (4.6-17.9) months for pts treated with RT before,
concomitant and after TKI, respectively. Median OS was
19.3 months and 1 and 2 yrs OS was 71.5% and 36.5%,
respectively. Stereotactic RT group showed an apparent
significant benefit in term of OS (p= 0.043). Fourteen pts
reported G1-2 toxicities (7 neurological symptoms, 3 pain
and 4 emesis), none determined the suspension of RT. No
dermatitis were observed.
.
Conclusion
Biological targeted therapy with TKI is a recent
opportunity to treat stage IV NSCLC with EGFR mutations
or ALK translocation but scarce data are available on the
effects of combined treatment. Our analysis shows that RT
concomitant to TKI is feasible and safe with satisfying OS
and RT related toxicities were not higher than expected.
EP-1220 Sites of recurrent disease and prognostic
factors in SCLC patients treated with
radiochemotherapy
R. Bütof1, C. Gumina2, C. Valentini1, A. Sommerer1, S.
Appold1, D. Zips3, S. Löck4, M. Baumann 1, E.G.C. Troost 1
1University Hospital and Medical Faculty Carl Gustav
Carus Dresden, Department of Radiation Oncology,
Dresden, Germany
2San Raffaele Scientific Institute Milano, Department of
Radiotherapy, Milano, Italy
3Eberhard-Karls-Universität Tübingen, Department of
Radiation Oncology, Tübingen, Germany
4OncoRay, National Center for Radiation Research in
Oncology, Dresden, Germany
Purpose or Objective
Concurrent radiochemotherapy (RCHT) is the standard
treatment in locally advanced small cell lung cancer
(SCLC) patients. Due to conflicting results on elective
nodal irradiation (ENI) or selective node irradiation (SNI)
there is no clear evidence on optimal target volumes.
Therefore, the aims of this study were the evaluation of
sites of recurrent disease in patients with limited stage
SCLC undergoing radiochemotherapy to assess the
feasibility and safety of SNI versus ENI and, moreover, the
extraction of prognostic factors for loco-regional control,
freedom from distant metastases and overall survival.
Material and Methods
A retrospective single-institution study was performed in
54 consecutive patients treated with RCHT. After state-of-
the-art staging, all patients underwent three-dimensional
conformal radiotherapy to a total dose of 45 Gy in twice-
daily fractions of 1.5 Gy starting concurrently with the
first or second chemotherapy cycle. The gross tumour
volume (GTV) consisted of the primary tumour and SNI
visualized on CT and/or FDG-PET, or confirmed by
cytology. The clinical target volume (CTV) was obtained
by expanding the GTV, adjusting it for anatomical
boundaries, and electively adding the supraclavicular
lymph node stations. Thereafter, the CTV was expanded
to a planning target volume based on institutional
guidelines. Follow-up consisted of a 3-monthly chest x-ray
or CT-scan up to 5 years after RCHT. All sites of loco-
regional recurrences were correlated to the initial tumour
and dose delivered. The impact of potential prognostic
variables on outcome was evaluated using the Cox-
regression model.
Results