ESTRO 36 Abstract Book

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S654 ESTRO 36 2017
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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 ⅢA or ⅢB）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. Mitsuyoshi1, Y. Matsuo1, T. Shintani1, Y. Iizuka1, W.A.
Mampuya1, H. Nagai2, H. Ozasa 2, Y.H. Kim 2, T.F. Chen-
Yoshikawa3, M. Sonobe3, N. Nakajima4, A. Yoshizawa4, T.
Mizowaki1, H. Date3, M. Hiraoka1
1Kyoto University Hospital, Department of Radiation
Oncology and Image-Applied Therapy, Kyoto, Japan
2Kyoto University Hospital, Department of Respiratory
Medicine, Kyoto, Japan
3Kyoto University Hospital, Department of Thoracic
Surgery, Kyoto, Japan
4Kyoto 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
differences existed between the AHF and CF groups in
gender, age, clinical stage or histology. A total of 40
patients (78%) had experienced lymph node metastasis
before treatment. Patients received radiotherapy using
AHF in 17 cases and CF in 34 cases. All patients underwent
thoracotomy after induction CRT. The median duration
between the last day of radiotherapy and the day of
operation was 35 days (range, 16–70). The pathologic
complete response (pCR) rates in the primary tumor and
dissected lymph nodes are shown in Table 1. The pCR rates
of adenocarcinoma after induction CRT in the AHF and CF
groups were 41% (7/17) and 24% (8/34) in the primary
tumor and 50% (8/16) and 50% (12/24) in the dissected
lymph nodes, respectively. The pCR rates of SqCC after
CRT in the AHF and CF groups were 75% (6/8) and 29%
(4/14) in the primary tumor and 63% (5/8) and 64% (7/11)
in dissected lymph nodes, respectively. The SqCC in the
primary tumor had significantly higher pCR rates under
AHF compared to CF (p = 0.02). However, the pCR rates of
adenocarcinoma after CRT in the AHF and CF groups were
similar in both the primary tumor and dissected lymph