Seng Hup Chia MBChB, Presenter: Nothing to Disclose

Su Woon Kim, Abstract Co-Author: Nothing to Disclose

Kam Weng Fong, Abstract Co-Author: Nothing to Disclose

Whee Sze Ong, Abstract Co-Author: Nothing to Disclose

Swee Peng Yap, Abstract Co-Author: Nothing to Disclose

Tian Rui Siow, Abstract Co-Author: Nothing to Disclose

Anuradha Thiagarajan, Abstract Co-Author: Nothing to Disclose

Yoke Lim Soong, Abstract Co-Author: Nothing to Disclose

ObjectivesStereotactic body radiation therapy (SBRT) is a well established treatment option for medically inoperable stage I lung cancer patients. Several studies have shown its benefits in local control and survival. We report the first outcomes of lung cancer patients treated with SBRT at our institution and the factors that influence the outcome.Materials and methodsAll stage 1 lung cancer patients treated with SBRT since the technique was introduced in our hospital was retrospectively reviewed. Patients were identified using radiotherapy department electronic records and the details of patient characteristics, diagnosis and treatments were collected. Survival distributions were estimated using Kaplan-Meier method and univariate Cox regression analyses were performed. Toxicities were graded using common terminology criteria for adverse events (CTCAE) version 4.ResultsA total of thirty five stage I lung cancer patients were treated with SBRT between May 2009 and November 2012. Median follow-up was 20.3 months. Thirty four patients (97%) had biopsy proven primary lung cancer. Twenty one patients (60%) were treated with 48 Gy in 4 fractions and the remaining patients were treated with 60 Gy in 5 fractions. At the time of analysis three patients developed local relapse and seventeen developed regional and/or distant relapse. Thirteen deaths were observed of which ten were due to lung cancer. Local relapse free survival, overall survival (OS) and cancer specific survival (CSS) at 2 years was 85 %, 65.4 % and 70 % respectively. Univariate analysis showed significantly higher rates of OS in patients who underwent pre-treatment PET-CT scan (HR 0.23, 95% CI: 0.07 - 0.72; p=0.006). Higher numbers of regional and distant relapses were seen in stage IA patients where only 68% of the patients underwent PET scan compared to 100 % in stage IB (HR 0.21, 95% CI: 0.05-0.98; p=0.033) The presence of an active synchronous cancer was associated with lower rates of OS (HR 10.78, 95% CI: 1.95 - 59.69; p=0.001). Clinically significant grade 2 and above toxicities were seen in rib fracture (11%), dyspnoea (12%), cough (9%), pleural effusion (9%), chest wall pain (6%) and fatigue (3%).ConclusionsSBRT remains an important treatment option for medically inoperable stage I lung cancer patients. Pre-treatment PET-CT scan has a significant association with survival. This could be accounted for by the improved staging accuracy and is thus recommended for all patients planned for SBRT.

Chia, S, Kim, S, Fong, K, Ong, W, Yap, S, Siow, T, Thiagarajan, A, Soong, Y, Stage I Lung Cancers Treated with Stereotactic Body Radiation Therapy (SBRT): Comparable Results in a South-east Asian Population.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14041645.html