71P - Outcome after SBRT for potentially operable NSCLC patients

Date 17 April 2015
Event ELCC 2015
Session Poster lunch
Topics Non-Small-Cell Lung Cancer, Early Stage
Surgery and/or Radiotherapy of Cancer
Presenter Maddalena Rossi
Citation Annals of Oncology (2015) 26 (suppl_1): 18-23. 10.1093/annonc/mdv048
Authors M. Rossi1, H. Peulen2, H. van Tinteren3, M. Wouters4, J. Sonke1, P. Baas5, E.F. Smit5, J. Belderbos1
  • 1Radiotherapy, The Netherlands Cancer Institute, 1066 CX - Amsterdam/NL
  • 2Radiotherapy, The Netherlands Cancer Institute, Amsterdam/NL
  • 3Biometrics Department, The Netherlands Cancer Institute, Amsterdam/NL
  • 4Surgical Oncology, The Netherlands Cancer Institute, Amsterdam/NL
  • 5Thoracic Oncology, The Netherlands Cancer Institute, Amsterdam/NL

Abstract

Aim/Background

Stereotactic Body Radiotherapy (SBRT) is a treatment option for stage I (T1-2aN0M0) primary Non-Small Cell Lung Cancer (NSCLC). As surgery is the primary treatment choice for these tumors, most patients receiving SBRT are medically inoperable patients. More recently there has been an increase in patients refusing surgical treatment in favor of SBRT because of high local control rates and low toxicity1. To date, no randomized trial comparing SBRT to surgery has been reported in literature. We evaluated the overall survival (OS) of the medically operable patients with stage I NSCLC refusing surgery, within a large cohort receiving SBRT in our institute, and compared this to our surgical stage I overall survival outcome.

Methods

Patients received SBRT for peripheral stage I lung tumors from 2006-2012 with prescribed doses of 3x18Gy treated in 8-11 days. Volumetric image guided radiotherapy was used for tumor position and setup verification. Only medically operable patients who refused surgical treatment were included in this cohort. Patients presenting with synchronous lung tumors or prior SBRT were excluded from the analysis. The second cohort of patients underwent surgery for stage I lung tumors from 2006-2012. Patients receiving chemotherapy prior to or after surgery (n = 26) were excluded. Overall Survival was compared for both groups with a Logrank test for significance.

Results

Out of 517 patients receiving SBRT, 42 had refused surgery: average age 74.2 years, 50% male, 50% female and T1 = 35 (83%), T2a = 7 (17%) tumors, with a median follow-up of 24.2 months. In the surgical cohort, 66 patients were identified: average age was 63.9 years, 45% male, 55% female, T1 = 52 (78%), T2a = 15 (22%) tumors, with a median follow-up of 29.5 months. The 1- and 3-year survival for the SBRT and surgical groups were 94.3 % (SE 3.9 %) and 79.8% (SE 7.6 %), vs 93.6% (SE 3.1%) and 80.6% (SE 5.7 %) respectively (Logrank p = 0.286).

Conclusions

The OS after SBRT of patients refusing surgery with stage I NSCLC (peripheral located) showed no significant difference to the surgically treated stage I NSCLC patients, despite the age of the SBRT ‘refusal’ patients being considerably higher. 1Grills et al. J Thorac Oncol. 2012.

Disclosure

All authors have declared no conflicts of interest.