Journal Thoracic Oncology

Abstracts Journal of Thoracic Oncology • Volume 12 Issue S1 January 2017
Ib/II 51/49%, squamous/non 30%/70%, wedge/lobectomy/pneumonectomy
8/76/16%, adjuvant chemotherapy 46%. Adherence to 4 interventions in 2
y: clinic visits 62%, CT scans 18%, visit and/or CT 67%. Multivariate analysis
(MVA) for predictors of guideline adherence demonstrated only stage was
significant. Recurrence rate was 46% at 2 y with patterns of recurrence and
treatment in table 1. Surveillance below vs per/above guidelines; PFS 26.6 m vs
22 m (p=0.54), OS 47 m vs 41.8 m (p=0.27).
Recurrence within
2 years
Method of
detection
Follow up
visits and/or
CT scans below
guidelines n=87
Follow up visits
and/or CT scans
per or above
guidelines
n=176
32 (37%) 88 (50%)
Surveillance 18 (56%) 41 (47%)
Patient 14 (44%) 47 (53%)
Distribution of
recurrence
Second primary 1 (3%) 2 (2%)
Locoregional
recurrence only
10 (31%) 14 (16%)
Metastatic 21 (66%) 73 (82%)
Curative intent
treatment at
recurrence
Palliative
chemotherapy
p
value
0.41
0.16
5 (16%) 6 (7%) 0.16
7/27 (26%) 32/82 (39%) 0.25
Conclusion: Compliance with follow up recommendations for resected NSCLC
was 67% in our study. Guideline conformity did not increase the rate of
curative intent therapy at recurrence due to metastatic presentation nor did
it increase the proportion of patients treated with palliative chemotherapy.
Better adjuvant treatment and surveillance options need to be developed for
resected NSCLC.
Keywords: Surveillance, recurrence, guidelines, Post operative NSCLC
POSTER SESSION 1 - P1.05: EARLY STAGE NSCLC
MISCELLANEOUS –
MONDAY, DECEMBER 5, 2016
P1.05-061 INCREASED TREATMENT-RELATED TOXICITY IN
PATIENTS WITH EARLY-STAGE NON-SMALL CELL LUNG CANCER
AND CO-EXISTING INTERSTITIAL LUNG DISEASE
Hanbo Chen 1 , Alexander Louie 1 , Esther Nossent 2 , Gabe Boldt 3 , David Palma 1 ,
Suresh Senan 4
1 Radiation Oncology, London Health Sciences Centre, London/ON/Canada, 2 VU
University Medical Center, Amsterdam/Netherlands, 3 Library Services, London
Regional Cancer Program, London/ON/Canada, 4 Radiation Oncology, VU University
Medical Center, Amsterdam/Netherlands
Background: Treatment options for early-stage non-small cell lung cancer
(ES-NSCLC) are generally well-tolerated. Minimally-invasive surgical
techniques, stereotactic ablative radiotherapy (SABR) and radiofrequency
ablation (RFA) can all achieve post-treatment mortality of grade 3 was 12%, 25%, 25%, 12.5% and
20%, respectively. For patients treated with surgery, 5-year overall survival
(OS) was 31.4% to 61.6% (median 54.2%) for patients with ILD and 70.5% to
88.3% (median 83.0%) for patients without ILD. For medically inoperable
patients treated with SABR, 2 to 3-year OS was 0% to 53.8% (median 48.8%)
for patients with ILD and 54% to 86.7% (median 70.8%) for patients without
ILD. Studies that included only patients with idiopathic pulmonary fibrosis
reported higher treatment-related toxicity compared to other studies.
Conclusion: An elevated level of treatment-related toxicity is observed in
patients treated for ES-NSCLC with co-existing ILD. Medically inoperable
patients experienced high levels of treatment-related mortality. For surgery
and SABR, overall survival was worse for patients with ILD compared to those
without ILD.
Keywords: interstitial lung disease, Surgery, stereotactic ablative radiation
therapy, non-small cell lung cancer
POSTER SESSION 1 - P1.05: EARLY STAGE NSCLC
MISCELLANEOUS –
MONDAY, DECEMBER 5, 2016
P1.05-062 IS LUNG MICROWAVE THERMOABLATION A VALID
ALTERNATIVE TO SURGERY IN HIGH RISK PATIENTS? A PROPENSITY
MATCH ANALYSIS
Paolo Mendogni 1 , Davide Tosi 1 , Alessandro Palleschi 1 , Lorenzo Rosso 1 , Ilaria
Righi 1 , Matteo Montoli 1 , Francesco Damarco 1 , Claudia Bareggi 2 , Cristina
Marenghi 3 , Mario Nosotti 1
1 Thoracic Surgery and Lung Transplantation Unit, Fondazione IRCCS Ca’ Granda
- Ospedale Maggiore Policlinico, Milan/Italy, 2 Oncology, Fondazione IRCCS Ca’
Granda - Ospedale Maggiore Policlinico, Milan/Italy, 3 Anesthesiology and Critical
Care, Fondazione IRCCS Ca’ Granda - Ospedale Maggiore Policlinico, Milan/Italy
Background: Surgery is considered the best treatment in Stage I non small
cell lung cancer. Local non–surgical therapies (radiotherapy, thermoablation)
are becoming valid alternative to surgery in high risk patients (poor cardiac
or pulmonary function, elderly patients). Methods: Patients submitted in
our Department to Microwave thermoablation (MW) were compared with a
cohort of patient submitted to lung lobectomy in the same period of time,
abstracted from our database with a propensity match method. The study
was retrospective on data recorded prospectively. Primary endpoint was
overall survival. Results: From June 2009 to October 2014 in our Department,
36 patients underwent MW for Stage I non-small cell lung cancer (NSCLC)
or lung metastasis. From our database were abstracted 41 patients with
a propensity match method, submitted to lung lobectomy. Two groups
were comparable by age, diagnosis, stage and gender. MW group resulted
elder than Surgery group (75,5 vs 72,2 years; p