ESTRO 2022 - Abstract Book

S1080

Abstract book

ESTRO 2022

(3) Wijsman et al. R&O 2015;117:49-54. (4) www.nvro.nl

PO-1281 Hypofractionation in locally advanced NSCLC: outcome, toxicity and predictive factors

D. Franceschini 1 , A. Marzo 2,3 , L. Lo Faro 4,3 , B. Marini 4,3 , L. Di Cristina 4,5 , C. Franzese 4,5 , C. Galdieri 4 , M. Massaro 6 , R. Spoto 4 , L. Dominici 4 , M. Scorsetti 6,3 1 IRCCS Humanitas Research Hospital, Radiotherapy and Radiosurgery, Rozzano, Milan, Italy; 2 IRCCS Humanitas Research Hospital, Radiotherapy and Radiosurgery, Rozzano-Milan, Italy; 3 Humanitas University, Biomedical Sciences, Pieve Emanuele – Milan, Italy; 4 IRCCS Humanitas Research Hospital, Radiotherapy and Radiosurgery, Rozzano – Milan, Italy; 5 Humanitas University, Biomedical Sciences , Pieve Emanuele – Milan, Italy; 6 IRCCS Humanitas Research Hospital, Radiotherapy and Radiosurgery, Rozzano – Milan, Italy Purpose or Objective The aim of this study was to evaluate clinical outcome, toxicity and predictive factors of recurrence and mortality in a cohort of patients treated with hypofractionated sequential chemo-radiotherapy (CT-RT) or exclusive radiotherapy (RT) for locally advanced non-small cell lung cancer (LA-NSCLC). Materials and Methods The study included patients affected by LA-NSCLC (stage II-IVA) treated with sequential CT-RT or exclusive RT. RT was delivered in 20 fractions for a total dose of 50-60 Gy with Volumetric Modulated Arc Therapy (VMAT). We excluded patients receiving adjuvant immunotherapy after CT-RT. Acute and late toxicities were recorded according to CTCAE v5.0. The Kaplan Meier analysis was applied to assess local control (LC), progression-free survival (PFS) and overall survival (OS). Univariate analysis was used to correlate outcomes to prognostic factors of recurrence and mortality. Results Between 2011 and 2019, 210 patients were treated with hypofractionated RT, 113 patients (53,8%) with sequential CT-RT and 97 patients (46.2%) with exclusive RT. Patients and treatment characteristics are shown in table 1. After a median follow up of 16.5 months (range 1.9 – 94.1 months), 74 patients (35.2%) had a local progression and 133 patients (63.3%) had a distant progression. One, two and 5-year LC rate were 73.6% (95% CI 66.2% - 79.6%), 55.3% (95% CI 46.5% – 63.2%) and 47.9% (95% CI 38,1 – 57%), respectively. At the time of analysis 167 patients (79.5%) died. One, two and 5-year OS rate were 64.7% (95% CI 57.8% - 70.7%), 36% (95% CI 29.5% - 42.6%) and 20% (95% CI 14.2% - 25.8%), respectively. PTV volume, as a continuous variable, correlated with OS (p=0.056), PFS (p=0.001) and LC (p=0.005). Exclusive RT was correlated with a worse OS (with a borderline statistically significance, p=0.07). We recorded a better outcome in terms of LC and OS of the sequential regimen after 2 and 5 years compared to the exclusive one: 62% vs 46.6% at 2 years and 54% vs 40% at 5 years for LC, and 41% vs 30% at 2 years and 27% vs 11.6% at 5 years for OS. Acute toxicity was recorded in 82% of patients, while late side effects occurred in 26% of cases. The most common acute toxicities were grade 1 and 2 and included asthenia (21,8%), dyspnea (11,9%), dysphagia (41,4%), cough (32,3%). Two patients had G3 pneumonitis and one patient had G5 pneumonitis. Late esophageal toxicity and dyspnea occurred in 6 and 16 patients, respectively. There were 9 cases of G4 pneumonitis and one patient with G5 pneumonitis. Toxicities are listed in table 2. Conclusion Hypofractionated sequential CT-RT or exclusive RT offer a good local control, a safe toxicity profile and a promising survival rate in LA-NSCLC patients unfit for concurrent CT-RT scheme. The target volume correlated with OS, PFS and LC and exclusive RT was associated with a worse OS compared to the sequential scheme. Larger prospective trials are necessary to evaluate toxicity and survival. R. Krishnatry 1 , A. ANUP 2 , A. Ramaswamy 3 , V. Chaudhari 4 , M. Bhandare 4 , S. Srinivas 3 , P. Bhargava 3 , V. OTSWAL 3 , A. Baheti 5 , S. Shrikhande 4 , R. Engineer 2 1 tata Memorial Centre, Radition Oncology, Mumbai, India; 2 tata Memorial Centre, Radiation Oncology, Mumbai, India; 3 tata Memorial Centre, Medical Oncology, Mumbai, India; 4 tata Memorial Centre, Surgical Oncology, Mumbai, India; 5 tata Memorial Centre, Radiology, Mumbai, India Purpose or Objective Outcomes for the borderline resectable (BRPC) and locally advanced pancreatic cancer (LAPC) remain poor despite treatment advances. We review the factors associated with outcomes in our institutional cohort of BRPC & LAPC receiving neoadjuvant chemotherapy (NACT) and stereotactic body radiotherapy (SBRT) followed by surgery when feasible. Materials and Methods We retrospectively analyzed the medical records of consecutive BRPC and LAPC patients treated with NACT for a median of 2 months, followed by SBRT (36-46 Gy over 5-6 fractions) from May 2015 to Dec 2020. Factors associated (p<0.05: significant) with overall survival (OS), disease-free survival (DFS), progression-free survival (PFS), local failure and distant metastasis-free survival (LFFS or DMFS) were estimated using Kaplan Meier and Log-rank test for univariate and multivariate analysis. Poster (digital): Upper GI PO-1282 Local control still a challenge in post-SBRT advanced Pancreatic cancer - A single institute series