1289PD - Clinical course in patients with stage III non-small cell lung cancer and interstitial lung disease treated with chemoradiotherapy: a retrospective...

Date 11 September 2017
Event ESMO 2017 Congress
Session Non-metastatic NSCLC and other thoracic malignancies
Topics Anti-Cancer Agents & Biologic Therapy
Cancer in Adolescents
Non-Small-Cell Lung Cancer, Locally Advanced
Cancer in Special Situations
Lung and other Thoracic Tumours
Surgery and/or Radiotherapy of Cancer
Presenter Haruki Kobayashi
Citation Annals of Oncology (2017) 28 (suppl_5): v457-v459. 10.1093/annonc/mdx379
Authors H. Kobayashi1, T. Naito1, K. Omae2, S. Omori1, K. Nakashima1, K. Wakuda1, A. Ono1, H. Kenmotsu1, H. Murakami1, M. Endo3, H. Harada4, T. Takahashi1
  • 1Thoracic Oncology, Shizuoka Cancer Center, 411-8777 - Shizuoka/JP
  • 2Clinical Research Promotion Unit, Clinical Research Center, Shizuoka Cancer Center, 4118777 - Sunto-gun/JP
  • 3Diagnostic Radiology, Shizuoka Cancer Center, 411-8777 - Shizuoka/JP
  • 4Radiation Oncology, Shizuoka Cancer Center, 411-8777 - Shizuoka/JP

Abstract

Background

Patients with non-small cell lung cancer (NSCLC) and interstitial lung disease (ILD) are often excluded from clinical trials because they are considered to be at high risk for acute exacerbation (AE) of ILD triggered by radiotherapy. Therefore, data on the clinical course in these patients are limited. We examined the relationship between chemoradiotherapy (CRT) and occurrence of AE of ILD as well as the clinical course in these patients at our institution.

Methods

A retrospective analysis was performed on 37 patients with stage III NSCLC and ILD treated with first-line CRT in a clinical setting between January 2009 and December 2014 at our institution.

Results

Patient characteristics are shown in Table 1. Patients treated with CRT had milder ILD than those treated with chemotherapy alone. Eighteen patients treated with CRT received corticosteroids for the treatment of AE of ILD. Univariate analysis revealed that the risk factors for AE of ILD were ILD classification, smoking history, and V20. In multivariate logistic regression analysis, the independent risk factor for AE of ILD was ILD classification. AE of ILD occurred in nine (82%) patients with usual interstitial pneumonia (UIP) pattern and in nine (35%) with non-UIP pattern. Median overall survival (mOS) was 34.6 months. Univariate analysis and multivariate logistic regression analysis revealed that the prognostic factor for patients with stage III NSCLC and ILD treated with CRT was ILD classification. mOS was 10.9 and 43.0 months in UIP and non-UIP patterns, respectively.rnTable:

1289PD

rnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrn
First-line treatment VariableChemoradiotherapyRadiotherapyChemotherapy
(N = 37)(N = 17)(N = 25)
Age, median (range)73 (52–85)80 (59–89)69 (58–81)
Sex, male/female32/515/221/4
PS, 0/1/215/22/06/7/410/15/0
Clinical staging (TNM classification, 7th edition), IIIA/IIIB20/178/910/15
Smoking history, yes/no33/416/124/1
Histology, squamous/non-squamous19/187/1013/12
ILD classification, UIP/non-UIP11/266/1116/9
%VC, median (range)96 (59–129)86 (62–112)85 (64–121)
V20, median (range)27 (12–35)26 (14–36)rn
Lung volume loss or honeycombing4413
rn

Conclusions

In conclusion, this retrospective analysis suggests that ILD classification (UIP or non-UIP) is associated with the occurrence of AE of ILD and prognosis in patients treated with first-line CRT.

Clinical trial identification

The study protocol was approved by the Institutional Review board of Shizuoka Cancer Center (28-J167-28-1-3).

Legal entity responsible for the study

Haruki Kobayashi

Funding

None

Disclosure

All authors have declared no conflicts of interest.