ESTRO 2024 - Abstract Book

S1635

Clinical - Lung

ESTRO 2024

LAT combined with pembrolizumab demonstrated improved PFS and OS compared to systemic therapy alone in selected patients with synchronous oligometastatic NSCLC. This RPA model can be used as a clinical tool to select appropriate patients for LAT. Further clinical trials are needed to characterize patients who would benefit most from this combination therapy.

Keywords: OIigometastasis, non-small cell lung cancer

949

Digital Poster

Safety and efficacy of Lung-SBRT in patients with severely reduced pulmonary function

Christoph Resl 1,2 , Johanna Salinger 1,2 , Dominik Frey 1,2 , Petra Georg 1,2

1 Karl Landsteiner University of Health Sciences, Division of Radiotherapy-Radiation Oncology, Krems an der Donau, Austria. 2 University Hospital Krems, Division of Radiotherapy-Radiation Oncology, Krems an der Donau, Austria

Purpose/Objective:

Stereotactic body radiotherapy (SBRT) is a valuable treatment option in medically inoperable early stage lung cancer patients. The most common reason for inoperability is reduced pulmonary function. The toxicity profile of SBRT has been shown to be favourable in these patients. However, there is lack of data reporting a threshold of pre treatment pulmonary function being safe for SBRT delivery. Therefore, the aim of the present study was to report on efficacy and safety of SBRT in patients with severe pulmonary restriction defined as FEV1 < 40%.

Material/Methods:

Twenty four patients with lung cancer treated between 12/2018 and 02/2022 were included into the analysis. Only 9/24 patients had histologic confirmation of non-small cell lung cancer due to tumour location and/or poor lung function. For non-biopsy proven patients, clinical criteria of malignancy were defined as hypermetabolism on PET CT and growth on sequential computed tomography. All patients showed a pulmonary baseline function FEV1 <40%. An ITV approach using all respiratory phases on 4D-CT was used for target delineation. Treatment was delivered using VMAT-SBRT technique with 54 Gy in 3 fractions, 50 Gy in 10 fractions or 60 Gy in 8 fractions depending on tumour size and location. The toxicity was scored according to CTCAE v5.0 at baseline, end of treatment and every 3 months thereafter for the next two years, followed by 6 months intervals for the next 3 years. Dyspnoea and cough were evaluated separately.

Results:

The cohort mainly consisted of elderly patients (mean age 69, 56-82) with severe comorbidities, with a mean Charlson comorbidity index of 7 (4-15). Mean FEV1 was 29,3% (39,9-16%) and 0,86l (1,39-0,37l). The mean diameter of treated lesions was 24,9mm (9-48mm).