675 / 1082
S659
ESTRO 36 2017
_______________________________________________________________________________________________
Out of 74 patients, 38 received BID and 36 received OD
CRT with no difference in number of cisplatin-etoposide
cycles between groups. In line with the institutional
policy, the BID cohort was younger (62 versus 68 years,
p=0.017), had smaller tumour volumes at planning CT (79
cc versus 127 cc, p=0.056), and tended to be in a better
general WHO performance status (PS) (45% versus 25% at
PS 0, p=0.075). At median follow-up of 9.4 months for
surviving patients, unadjusted as well as adjusted survival
(adjusted for age, WHO PS, stage and GTV) was not
significantly better for BID (HR=0.60, 95%CI 0.3–1.4 and
HR=0.70, 95%CI 0.3–1.8, respectively). PROMs regarding
dysphagia and dyspnea as well as physician-rated
toxicities and radiation pneumonitis were not different
between groups (figure). Mean esophageal V35 and mean
pulmonary V20 were different between BID and OD cohorts
(30 Gy versus 41 Gy; p=0.027, and 20 Gy versus 23 Gy;
p=0.061, respectively), in line with GTV differences
between groups.
Conclusion
Treatment selection based on tumour volume and patient
condition effectively limited PROMs and physician-rated
acute and late dysphagia in BID CRT. This can be explained
by the significantly lower esophageal V35 due to smaller
GTVs in patients receiving BID treatment. Also, acute and
late PROM-dyspnea and radiation pneumonitis did not
differ between BID and OD CRT. Treatment allocation
could be further improved by dose-volume-fractionation
modelling for esophagitis.
EP-1233 Early results of SBRT as a salvage treatment
after thoracic radiotherapy.
A. Navarro-Martin
1
, I. Guix
1
, J. Mases
1
, M. Mutto
2
, E.
Nadal
3
, F. Guedea
1
1
Institut Català d'Oncologia, Radiation Oncology,
L'Hospitalet de Llobregat, Spain
2
European Oncology Institue, Radiation Oncology,
Milano, Italy
3
Institut Català d'Oncologia, Medical Oncology,
L'Hospitalet de Llobregat, Spain
Purpose or Objective
Isolated intrathoracic relapse is common across distinct
tumors and especially in lung cancer. Patients who
received previous radiotherapy treatment (PRT) are not
suitable for salvage surgery and chemotherapy provides
poor local control. This study aimed to assess the toxicity
and outcome of SBRT re-irradiation (reRT) in patients with
solid tumors who developed an intrathoracic relapse.
Material and Methods
35p treated with PRT who received salvage SBRT were
identified in our database and their medical records were
retrospectively
reviewed.
All
patients
underwent complete pulmonary function tests (cPFTs)
(including DLCO, FEV1 and FVC) and PET-CT scan was
performed before and after receiving lung reRT.
Treatment planning was based on image fusion with the
previous treatment plan and calculating the cumulative
total nominal dose. Survival estimations were performed
using Kaplan-Meier and differences between PFTs prior
and post-reRT were analyzed using Student T-Test. Early
toxicity was defined when it occurred up to 6 months.
Results
Median age: 68 (r53-81); 29p (83%) were male The previous
treatments SBRT in 17p (49%), 3D-RT 4p (11%) and CT+RT
14p (40%) Mean RT dose 60,4Gy (r34-74). Primary tumors:
lung 24 (69%), colorectal 9 (25%), oesophagus 2 (6%). For
lung cancer p, the stage distribution was: IA 8 (23%), IB 2
(6%), IIA 2 (5.7%), IIB 1 (3%), IIIA 5 (4%), IIIb 4 (11%), IV 2
(6%). For other primaries, 8p (23%) were non metastatic at
diagnosis and developed oligoprogressive disease in thorax
which was treated with SBRT and 3 (8.5%) were
oligometastatic. The location of reRT site: same lobe 17
(48%), ipsilateral different lobe 7 (20%), contralateral
lobes 11 (32%). Median delivered dose of salvage SBRT was
50Gy (50-60) in 10 fractions (r3-10). Median accumulated
dose in the lung was 81Gy (r60.10Gy-176Gy).
With a median follow-up of 10m local control rate was 74%
(IC95%; 0.59-0.9) and 1-year OS was 84% (IC 95%;0.67-1).
The metabolic complete response rate was 23%. No
differences in the baseline and post re-irradiation PFTs
were observed: FEV1, FVC and DLCO difference and CI95%
were 2.41 (-1.79-6.62); 65 (-125-257) and 12.5 (-95 - 121).
Asthenia GII in 12p (31%) was the most frequent acute
toxicity, no long-term toxicities were detected.
Conclusion
Salvage SBRT for treating isolated intrathoracic relapses
achieved an outstanding local control and overall survival
in selected p . This treatment did not impair post-
reirradiation PFT and long-term toxicities were not
observed.
EP-1234 Prophylactic Cranial Irradiation (PCI) in Small-
Cell Lung Cancer: a single-institution experience.
M. Konkol
1
, M. Matecka-Nowak
1
, M. Trojanowski
2
, A.
Kubiak
2
, P. Milecki
1
1
Greater Poland Cancer Centre, I Radiotherapy Dept.,
Poznan, Poland
2
Greater Poland Cancer Centre, Greater Poland Cancer
Register, Poznan, Poland
Purpose or Objective
In 2013 1.963 (ASR 33,6/10
5
) new lung cancer cases and
1.855 (ASR 31,1/10
5
) lung cancer deaths were reported in
Greater Poland. Compared to 1999 the number of new
cases rose by 21% and the number of deaths rose by 16%.
In the group of lung cancer patients from the Greater
Poland population, diagnosed during 2009-2011, 80% were
microscopically verified, among them 79,9% were NSCLC
and 20,1% were SCLC. Prophylactic Cranial Irradiation
(PCI) in SCLC patients remains an important part of the
treatment process associated with a reduction of brain
metastases and better survival. This paper is a
retrospective review of 146 patients irradiated in Greater
Poland Cancer Center, Poznan, Poland.
Material and Methods
Eighty limited SCLC (LSCLC) and sixty six extensive SCLC
(ESCLC) patients irradiated in Greater Poland Cancer
Center between 2007-2010 received a standard scheme of
25Gy/10fx with 6MV photons. The qualification based on
X-ray post-chemotherapy assessment described as
significant partial response or complete response. Mean
time from the diagnosis date to the end of treatment was
6 months. The survival data were collected from the
national and regional cancer registers.
Results
Mean observed survival in our patients was 16,8 months
(13,6 months for ESCLC and 19,5 months for LSCLC). The
1-, 3- and 5-year observed survival rates were 74,12%,
9,52%, 4,70% for LSCLC and 48,48%, 1,49% 1,49% for ESCLC.
For our group as a whole respectively: 65%, 8,6%, 3,3%.
After radiotherapy, LSCLC and ESLCL patients survived 7,4
and 12,7 months on average. Grade 3 or 4 toxicity has not
been noticed.