Journal Thoracic Oncology

Abstracts Journal of Thoracic Oncology • Volume 12 Issue S1 January 2017
After median of follow up of 33 months (r 10-45) we analyzed 27p, with median
age of 74y (r 83-58), 21 males (78%). Main reasons for inoperability were: 7
(26%) poor respiratory function, 10 (37%) with multiple comorbidities and
6 (22%) who refused surgery. Location was RUL 9 (33%), RLL 6 (22%), LUL 7
(26%), LLL 4 (15%). Lung primaries in 19p (70%) and the main histologies were
Squamous Carcinoma (7, 26%) and Adenocarcinoma (7, 26%). T1a (9, 33%), T1b
(7, 26%),T2a (5, 18%) and T3 (2, 7%). Maximum grade of acute toxicity was GIII
1p(asthenia), and for chronic toxicity was GII (asthenia) 4p (15%). Local Control
at 30 months was 84% (three local failures, two from metastasis) and overall
survival was 100% at this time. Conclusion: FFF beams using dose risk adapted
schedule seem to be a safe approach with a good response profile. Further
analysis with the entire cohort of the trial is needed in order to confirm these
early results.
Keywords: SBRT, Lung, Trial
POSTER SESSION 2 – P2.05: RADIOTHERAPY
RT TECHNIQUES –
TUESDAY, DECEMBER 6, 2016
P2.05-036 SINGLE FRACTION OF SBRT FOR PULMONARY LESIONS
Neus Aymar 1 , Arturo Navarro-Martin 2 , Mª Dolores Arnaiz 3 , Ricard Ramos 4 ,
Samantha Aso 4 , Ismael Sancho 3 , Ferran Guedea 3
1 Radiation Oncology, Son Espases, Mallorca/Spain, 2 Radiation Oncology
Department, Catalan Institute of Oncology -Ico Hospitalet, Barcelona/Spain,
3 Catalan Institute of Oncology, Barcelona/Spain, 4 Thoracic Surgery, Bellvitge
Hospital, Barcelona/Spain
Background: Nowadays pulmonary oligometastatic disease it´s a common
situation. SBRT for these patients is a feasible therapeutic choice. We present
our experience using single fraction of 34Gy in solitary lesions in Lung. The
main aim of this report is to show that single fraction of 34 Gy in lung lesions
is feasible, without toxicity and good response profile. Methods: 11 patients
with 11 metastatic pulmonary lesions were prospectively treated with single
dose of 34Gy. Inclusion criteria were: lesion size smaller than 2 cm, distance
from the chest wall and main bronchus tree higher than 2 cm, in metastatic
lesions primary tumour should be under control in PET scan. Patients were
treated using True Beam machine (VARIAN). In 6 cases treatments were
delivered without flattening filter beams. Median Age 68.7y (r51-82), Gender
distribution 3 women and 8 men, Histology: 4 cases (36.4%) were metastasic
lesions from rectum, 2cases (18.2%) were metastasic lesions from Colon), 3
(27.3%) were primary lesions from lung, 1 (9.1%) was metastasic lesions from
sigma and another 1 (9.1%) was from lachrimal gland. All patients underwent
4DCT for contouring. Inmobilization was done by thermoplastic mask (Lorca
Marin.S.A). Location: 4 cases (36.4%) were on the Right superior lobe (RSL),
3(27.3%) were on Left Superior Lobe (LSL), 2(18.2%) were on Medial Lobe
(ML), 1(9.1%) was on the Lingula and another 1 (9.1%) on Left Inferior Lobe
(LIL). Pulmonary function impact was annalyzed using pulmonary function
tests performed before and after treatment. Results: After 45 months of
follow up (r 8-45) no toxicity higher than grade 2 was detected. Dosimetric
characteristics: mean volume of GTV 1.46cc (r 0.6-4.1), mean volume of PTV
10.85 (r7.1-22.2), D Max oesophagus 4.84 (r 2.7-8.3), D max Heart 8.63 (r0.22-
30.07), D max trachea 6.09 Gy (r 0.3-11.1), Dmax skin 10.98(r7.0-14.4). Local
control and distant control at 20 months were 77% and 54% respectively.
Overall survival was 72% at this time . We detected a significant DLCO
impairment of 18% r(2.82-35.13) p=0,027. Conclusion: To sum up, even this is a
preliminary study with a small sample size, this fractionation scheme of SBRT
is fast and well tolerated. However, we have detected an impairment of DLCO,
so further study with bigger sample size is needed in order to stablish the
magnitude of this impairment.
Keywords: SBRT, Lung, Single Dose
POSTER SESSION 2 – P2.05: RADIOTHERAPY
RT TECHNIQUES –
TUESDAY, DECEMBER 6, 2016
P2.05-037 HIGHER RADIATION DOSE IS STILL PROMISING IN
PATIENTS WITH COMPLETE RESPONSE TO 50 GY OF EARLY
THORACIC RADIOTHERAPY WITH CHEMOTHERAPY?
Wan Jeon 1 , Sung-Ja Ahn 1 , Jae-Uk Jeong 1 , Young-Chul Kim 2 , In-Jae Oh 2
1 Radiation Oncology, Chonnam National University Hwasun Hospital, Jeonnam/
Korea, Republic of, 2 Lung and Esophageal Cancer Clinic, Chonnam National
University Hwasun Hospital, Jeonnam/Korea, Republic of
Background: For limited stage small cell lung cancer (LSCLC), early thoracic
radiotherapy (TRT) with chemotherapy and radiation dose more than 60Gy
has been suggested as standard therapy. We aim to evaluate the survival
outcomes in LSCLC patients with complete response (CR) to 50 Gy of TRT
with chemotherapy. Methods: One hundred and fifteen patients with LSCLC
who completed the TRT from August 2005 to March 2014 were reviewed
retrospectively. We evaluated the age, gender, smoking status, AJCC
stage, PET parameters, tumor volume, dose and timing of TRT, duration of
treatment, and prophylactic cranial irradiation (PCI) as a prognostic variables.
Gross tumor volume (GTV) was defined as the post-chemotherapy tumor
volume at the time of the first TRT planning and the pre-chemotherapy
involved lymph nodes. Clinical target volume (CTV) was defined as GTV with
minimum 7mm margin including the first echelon drainage lymph node
station. At the time of 50 Gy of TRT, follow up chest CT was performed to
all patient and only patients who showed non-CR received 10 Gy or more
radiation. Dose of TRT was median 50 Gy (range, 42 to 65 Gy). Ninety-seven
(84.3%) patients received concurrent chemoradiotherapy (CRT) and PCI was
performed in all eligible patients. Results: For all patients, median survival
was 27.8 months. Two & 3-year OS were 60.7% and 38.58%, respectively.
Sixty-five patients (56.5%) showed the complete response (CR) and fifty
patients (43.5%) showed non-CR. There was correlation between tumor
response to 50Gy of TRT and the ratio of GTV to CTV (p=0.008) or AJCC stage
(p=0.036). With univariate analysis, AJCC stage (p