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Poster Display session

196P - 5-year survival and safety of stereotactic ablative radiotherapy in unresectable locally advanced non-small cell lung cancer patients unfit for concurrent radiochemotherapy: Focus on patterns of local recurrence from the START-NEW-ERA non-randomized phase II trial

Date

28 Mar 2025

Session

Poster Display session

Presenters

Fabio Arcidiacono

Citation

Journal of Thoracic Oncology (2025) 20 (3): S123-S150. 10.1016/S1556-0864(25)00632-X

Authors

F. Arcidiacono1, P. Anselmo1, M. Casale1, C. Zannori2, V. Tassi2, A. Guida2, B. Enrico3, M. Nunzi3, M. Ragusa2, F. Loreti4, M. Italiani1, F. Trippa1

Author affiliations

  • 1 Radiotherapy Oncology Centre "S.Maria" Hospital, Terni/IT
  • 2 Azienda Ospedaliera Santa Maria di Terni, Terni/IT
  • 3 Radiology Service, Terni/IT
  • 4 Nuclear Medicine Service "S.Maria" Hospital, Terni/IT

Resources

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Abstract 196P

Background

Purpose: In the early analysis of START-NEW-ERA phase II trial, SAbR had optimal local control (LC) and promising OS without ≥G3 toxicity in unresectable LA-NSCLC patients unfit for concurrent chemo-radiotherapy. We report the 5-year outcomes with focus on patterns of local recurrence (LR).

Methods

and Materials: SAbR was delivered by V-MAT to primary tumor (T) and regional nodes (N) based on PET-CT. When thoracic failures occurred, we matched the SAbR planning with PET-CT images to accurately assess the LR location, precisely to determine in-field versus out-field recurrence, looking at the specific isodose line within which the LR occurred.

Results

50 unresectable LA-NSCLC patients unfit for concurrent ChTRT were enrolled. Median dose was 45 Gy and 40 Gy in 5 daily fractions to T and N, respectively. After a median follow-up of 72 months (range, 10–108) the 3-, 5-year PFS rates were 26 ± 6%, 26 ± 6%. The 3-, 5-year OS rates were 70 ± 6%, 46 ± 7%. No patients developed ≥G3 late toxicities. The 3-, 5-year LR-FS rates were 64 ± 7%, 64 ± 7%, respectively. Multivariate analysis revealed SCC (p 0.016) and SAbR dose

Conclusions

The 5-year outcomes of START-NEW-ERA trial confirm robust and sustained benefit in terms of safety and effectiveness of SAbR in LA-NSCLC patients unfit for concurrent chemo-radiotherapy. Clinical trial identification: NCT05291780.

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.

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