ESTRO 2020 Abstract book

S130 ESTRO 2020

mean change in Intrathoracic symptom burden index (ISBI, defined as the average of 4 components based on items from EORTC QLQ LC13) from baseline to 6 weeks from end of treatment between arms, using a linear regression model. Each of the four symptoms included in the index were assessed separately to assess relative relief, using the Cochran test for ordinal data from a 2x6 contingency table. The sample size of 130 patients was based on the ability to show a mean difference between arms of 10 points in the ISBI. Results The trial closed early due to slow accrual. 76 patients (60% Stage IV, 30% Stage III) were randomised. Symptoms included cough (60% ), dyspnoea (40%), haemoptysis (24% ) and pain (50%). The ISBI was significantly lower at 6 weeks compared with baseline in the entire cohort with no significant difference between trial arms. For the component symptoms, at 6 weeks there was a statistically significant improvement in cough, haemoptysis and chest pain compared with baseline but no difference between trial arms. For dyspnoea, there was no significant difference between baseline and 6 weeks or between trial arms. The median survival time for the entire cohort was 13.9m, median survival of 12.4m for HDPRT and 15m for C-HDPRT (ns). There was no difference in Grade 2 or higher oesophagitis between arms. The incidence of Grade 3 fatigue, neutropenia and anorexia were higher in the C-HDRT arm Conclusion The results are in agreement with 2018 ASTRO guideline recommending the administration of a platinum- containing doublet concurrently with moderately hypofractionated palliative RT in patients with Stage III NSCLC deemed unsuitable for curative therapy. This study demonstrates that this is a an acceptable approach in selected patients with Stage IV NSCLC. The results also provide rates of symptom relief achievable with modern palliative RT regimens. OC-0230 Soft tissue match and adaptive radiotherapy reduce incidence of radiation pneumonitis C.M. Lutz 1 , D.S. Moeller 2 , L. Hoffmann 2 , A. Appelt 3 , A. Khalil 2 , M. Kandi 2 , M.I. Holt 2 , H.H. Schmidt 2 , M. Alber 4 , M.M. Knap 2 1 Aarhus University Hospital, Department of Oncology, Aarhus C, Denmark ; 2 Aarhus University Hospital, Department of Oncology, Aarhus, Denmark ; 3 University of Leeds, Leeds Institute of Medical Research at St James’s, Leeds, United Kingdom ; 4 Heidelberg University Hospital, Heidelberg Institute for Radiation Oncology, Heidelberg, Germany Purpose or Objective Radiotherapy (RT) dose escalation for patients suffering from locally advanced non-small cell lung cancer (LA- NSCLC) could potentially reduce local recurrence rates. However, any benefit of treatment intensification may be limited by the risk of serious pulmonary side effects, the most prominent being radiation pneumonitis (RP). Tumor match and adaptive radiotherapy (ART) increase the precision of RT and thus allow for a reduction of treatment volume and, consequently, of the dose to the lung. In this study, we investigate the effect of ART on the incidence of radiation pneumonitis in a large retrospective patient cohort. Material and Methods Between 2007 and 2017, 537 consecutive LA-NSCLC patients (excluding patients in on-going trials) were treated with RT doses between 50 and 66Gy in 25 to 33 fractions, 5 fraction/week. IMRT was gradually introduced between 2009 and 2011 while ART based on daily cone- beam CT soft tissue match was introduced for all patients in April 2013. To investigate the effect of ART on RP, the cohort was divided in two groups, pre-ART (284 patients)

Conclusion NSCLC patients with lung fibrosis have poor OS after curative-intent thoracic radiotherapy. FEV1 and COPD severity scores are not prognosticators and should not be considered absolute contraindications for curative-intent thoracic radiotherapy in NSCLC patients. Prospective studies with functional and quality of life assessments are needed to further refine radiotherapy treatment in these patients. OC-0229 TROG11.03 Phase III Trial Palliative RT versus CTRT in NSCLC patients not suitable for radical CTRT M. Lehman 1 1 Princess Alexandra Hospital, Department of Radiotherapy, Queensland, Australia Purpose or Objective This trial compared high dose palliative radiotherapy (HDPRT) with concurrent chemotherapy and HDPRT (C- HDPRT) in PS0-1 patients with locally advanced/ metastatic NSCLC not suitable for radical CRT with regard to: the relief of dyspnoea, cough, haemoptysis and chest pain as assessed by change in total symptom burden from baseline to six weeks after treatment completion and the response for each thoracic symptom separately. Secondary objectives were: incidence of dysphagia, duration of thoracic symptom response, QOL, toxicity, progression-free survival and overall survival. Material and Methods Patients 18 years or older, PS 0-1, Stage III or IV NSCLC with symptoms due to intrathoracic disease planned for HDPRT to achieve local control and symptom relief were eligible . Patients were randomised to 36Gy/12f versus 40Gy/20f with concurrent Cisplatin 20mg/m2 IV d1,8,15,22 and vinorelbine 25mg/m2 IV d 1,8,22 ( superior arm of TROG 03.07). The primary objective was assessed by comparing the