Abstract 5645
Background
Radiation induced CT changes may be apparent following completion of TRT. We sought to quantify differences in radiation-associated densities on serial CT scans of patients with ES-SCLC treated with TRT alone versus TRT followed by combined IPI and NIVO.
Methods
Between 2016 and 2018, patients at a single institution with ES-SCLC who achieved stable disease or better following initial treatment with platinum doublet chemotherapy were offered TRT and prescribed a total dose of 30Gy in 10 fractions targeting initially involved thoracic tumor sites. Combined IPI 3mg/kg and NIVO 1mg/kg was administered every 3 weeks for up to 4 doses. We evaluated an irradiated region of interest (ROI) within the lungs and a volume of lung (outside the Planning Target Volume) receiving > 20 Gy. Within the ROI, we calculated the Hounsfield unit (HU) mean for each patient prior to therapy and at subsequent follow-up CT thorax at least 60 days and closest to 120 days after commencing TRT. To quantify CT density change, we measured the difference in HU mean within the irradiated ROI before and after treatment.
Results
Seventeen patients enrolled on NCT03043599 received TRT followed by combined IPI/NIVO. Two additional patients received the same treatment off protocol. Eleven patients received TRT alone (no IPI/NIVO). The average increase in HU mean within 20Gy irradiated ROI before and after treatment was 9% (max 59%, min -19%) across the study cohort (n = 30). CTCAE grade 3 or higher pulmonary toxicity (N = 8 of 30) was significantly associated with increased CT density change within the ROI (mean 28% vs 2%, p = 0.001). Treatment with TRT and IPI/NIVO (N = 19 of 30) demonstrated a trend towards increased mean CT density change within the ROI compared to patients treated with TRT alone (mean 13% vs. 0%, p = 0.1).
Conclusions
Quantifying CT density change within irradiated lung parenchyma may offer a novel approach to predict radiation associated pulmonary toxicities. Measuring density changes across patient cohorts receiving TRT with novel systemic therapies may help to identify combined treatment strategies likely to be associated with diminished risk of toxicity.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Bristol-Myers Squibb.
Disclosure
S. Kim: Research grant / Funding (institution): Bristol-Myers Squibb. S.A. Rosenberg: Advisory / Consultancy: Novocure. J.E. Gray: Honoraria (self), Advisory / Consultancy, Research grant / Funding (institution): AstraZeneca; Honoraria (self), Advisory / Consultancy: Celgene; Honoraria (self), Advisory / Consultancy: Takeda; Honoraria (self), Advisory / Consultancy: Janssen; Honoraria (self), Advisory / Consultancy, Research grant / Funding (institution): Genentech; Honoraria (self), Advisory / Consultancy: Eli Lilly; Honoraria (self), Advisory / Consultancy: Triptych Health Partners. S.J. Antonia: Advisory / Consultancy: Bristol-Myers Squibb; Advisory / Consultancy, Research grant / Funding (institution): Novartis; Advisory / Consultancy: Merck; Advisory / Consultancy: CBMG; Advisory / Consultancy: Boehringer Ingelheim; Advisory / Consultancy: AstraZeneca/MedImmune; Advisory / Consultancy: Memgen; Advisory / Consultancy: FLX Bio; Advisory / Consultancy: Nektar; Advisory / Consultancy: Venn. B. Perez: Advisory / Consultancy: Bristol-Myers Squibb; Advisory / Consultancy: AstraZeneca. All other authors have declared no conflicts of interest.
Resources from the same session
5822 - Greek nursing students experience facing death in clinical practice
Presenter: Maria Dimoula
Session: Poster Display session 3
Resources:
Abstract
2866 - HOPEVOL: Hospice care appropriate to the wishes and needs of patients in the palliative terminal phase.
Presenter: Merel van Klinken
Session: Poster Display session 3
Resources:
Abstract
829 - Mindfulness-based stress reduction in early palliative care for advanced cancer patients : an italian single-centre study. MINDEEP
Presenter: Emilia Gianotti
Session: Poster Display session 3
Resources:
Abstract
2702 - Optimising Inpatient Oncology Care
Presenter: Lisa Judge
Session: Poster Display session 3
Resources:
Abstract
1527 - Analysis on the Implementation Results of Family Sickbed for Oncology Patients in Dongshi Township Health Centers from 2015 to 2017
Presenter: Yayu Huang
Session: Poster Display session 3
Resources:
Abstract
2054 - Exploring needs for palliative care and quality of life for oncology patients with advanced disease who undergo radiotherapy
Presenter: Foteini Antonopoulou
Session: Poster Display session 3
Resources:
Abstract
5605 - Cytotoxic contamination in cancer care settings – Risks and safety awareness among cancer nurses
Presenter: Sandra Lundman Vikberg
Session: Poster Display session 3
Resources:
Abstract
5769 - Understanding Chemotherapy - group education sessions prior to commencing chemotherapy
Presenter: Aileen McHale
Session: Poster Display session 3
Resources:
Abstract
2620 - Estimation of HPQ-based absenteeism and presenteeism in cancer patients via ResearchKit
Presenter: Shunsuke Kondo
Session: Poster Display session 3
Resources:
Abstract
4705 - Identifying falls-related variables and risk factors in hospitalised cancer patients
Presenter: Maria Montserrat Martí Dillet
Session: Poster Display session 3
Resources:
Abstract