ESTRO 2022 - Abstract Book

S1070

Abstract book

ESTRO 2022

Considering the entire population, median PFS was 28.9 months and the 2-year OS was 70.8%. Besides, among our population study, 31% of patients presented at least one or more exclusion or non-inclusion criteria according to initial PACIFIC protocol. But there was no difference between the patients who meet the PACIFIC criteria and the others, whether for toxicity or survivals. The beginning of the durvalumab consolidation within 14 days after ending CRT seemed to improve the PFS according to PACIFIC’s findings. Conclusion In our real-word study, incidence of grade 3-4 radiation pneumonitis and immune pneumonitis are similar to those in the PACIFIC trial. Incidence of lung infections was higher, probably because of the context of SARS-CoV-2 pandemic. Age ≥ 68 years-old, cardiovascular history and use of docetaxel were found to be predictive factors for radiation pneumonitis. Moreover, PFS and OS were excellent.

PO-1268 SABR IN LA-NSCLC Elderly Patients Unfit To Concurrent Cht-Rt: Few Fractions For A Great Outcome!

F. Arcidiacono 1 , P. Anselmo 1 , M. Casale 1 , M. Italiani 1 , A. Di Marzo 1 , S. Terenzi 1 , S. Fabiani 1 , L. Draghini 1 , M. Muti 1 , E. Maranzano 1 , F. Trippa 1

1 Radiotherapy Oncology Centre, Oncology, Terni, Italy

Purpose or Objective Although the standard of care in LA-NSCLC is concurrent chemo-radiotherapy (ChT-RT), there is a lack of prospective trials regarding the best treatment in elderly patients. We enrolled in a phase II trial unresectable locally advanced non-small cell lung cancer (LA-NSCLC) elderly patients unfit to concurrent ChT-RT, to assess effectiveness and safety of stereotactic ablative radiotherapy (SABR) after neoadjuvant chemotherapy (ChT). Materials and Methods The cutoff of age ≥ 70 years was chosen as a commonly used definition of elderly in LA-NSCLC patients. All patients were unfit for concurrent chemo-radiotherapy (ChT-RT). The tumor volume included primary tumor (T) and CT-PET positive node/s (N). A simultaneous integrated boost (SIB) was optimized to differentiate the dose for primary tumor (T) and lymph- node/s (N). Results 27 LA-NSCLC elderly patients unfit for concurrent ChT-RT were recruited. Median age was 73 years (range,70-85) and 21 (78%) were male. Histology was squamous cell carcinoma (SCC) and adenocarcinoma (ADK) and in 17 (63%) and 10 (37%), respectively. The stage was IIB, IIIA, IIIB and oligometastatic IV in 2 (7%), 9 (33%), 10 (37%) and 6 (22%) pts, respectively. All patients had ultra-central tumor with PTV overlapping the major airways. In 14 (52%) cases T and N were separately treated using SIB technique to administer a higher dose to T. Median prescribed dose was 40 Gy (range, 35-50) and 40 Gy (35-45) in 5 fractions to T and N, respectively. During a median follow-up of 19 months (range, 4-45), 7 (26%) and 11 (41%) patients had experienced local recurrence (LR) and nodal regional recurrence at a median time of 9 (range, 4-24) and 9 months (range, 4-28), respectively. 11 (41%) patients developed distant metastases after a median time of 9 months (range, 3-27). At last follow-up, 21 (78%) patients were alive, 10 (48%) without radiological evidence of disease. Treatment compliance was 100% and no patients developed ≥ G3 acute and late toxicities. Conclusion In our prospective trial, SABR after neoadjuvant ChT in LA-NSCLC elderly patients was safe and effectiveness. The treatment compliance was excellent and no patients experienced ≥ G3 toxicity. Few fractions of SABR could represent an attractive option to obtain a great outcome in LA-NSCLC elderly patients unfit for concurrent ChT-RT.

PO-1269 SABR in locally-advanced non-small-cell lung cancer elderly patients: little palliation or big cure?

F. Arcidiacono 1 , P. Anselmo 1 , M. Casale 1 , M. Italiani 1 , S. Terenzi 1 , A. Di Marzo 1 , S. Fabiani 2 , L. Draghini 1 , M. Muti 1 , F. Trippa 1 , E. Maranzano 1

1 Radiotherapy Oncology Centre, Oncology, Terni, Italy; 2 Rdiotherapy Oncology Centre, Oncology, Terni, Italy

Purpose or Objective In clinical practice many elderly patients are unfit to chemotherapy (ChT) due to age and/or comorbidities and are candidates to palliative radiotherapy (RT). There is a lack of prospective trials regarding the best schedule treatment in this setting of patients. We enrolled in a phase II trial unresectable locally advanced non-small cell lung cancer (LA-NSCLC) elderly patients to assess effectiveness and safety of exclusive stereotactic ablative radiotherapy (SABR). Materials and Methods The cutoff of age ≥ 70 years was chosen as a commonly used definition of elderly in LA-NSCLC patients. All patients were unfit for concurrent and/or sequential ChT-RT. The tumor volume included primary tumor (T) and CT-PET positive node/s (N). A simultaneous integrated boost (SIB) was optimized to differentiate the dose for primary tumor (T) and lymph-node/s (N).