ESTRO 2024 - Abstract Book

S1816

Clinical - Lung

ESTRO 2024

Results:

In total, 285 patients were referred for radical radiotherapy for lung cancer in 2022. 251 of these (88%) received RR (see table 1). 34 (11%) did not. Of the patients who did not proceed to radical radiotherapy, 3 (9%) declined radical radiotherapy, 5 (15%) were not well enough to receive treatment, 18 (53%) were unable to have radical doses due to doses to normal organs (OAR) and received palliative radiotherapy or induction systemic therapy, 5 (15%) were upstaged with extra-cranial metastases and 1 was upstaged with cranial metastases (3%). Overall upstaging to metastatic disease occurred in 6 patients (2% of the 287 referred for radical radiotherapy). But it should be noted that 2 out of 6 (33%) of these cases were due to re-staging PET/CT scans which were only offered in 13% of those with out-of-date PET/CT, implying the actual rate of upstaging may have been a lot higher. Most patients referred had incomplete staging (PET/CT out of date in 69%, incomplete brain staging in 41%). Of all 287 patients, 97% had a PET/CT scan, but only 31% at the time of referral to radiotherapy had a PETCT within the recommended timeline. 24 patients had repeat PET/CT scans. The median interval between scans was 102 days (range 62 – 277). 2 patients were upstaged to stage IV disease. One patient was upstaged to N1 disease, and 5 to N2 disease. A further 10 patients had an increase in the primary tumour (42%), although this was also noted on the radiotherapy planning scan. Only 6 patients with restaging PET/CT had no change at all. As a result of incomplete staging, 36% of patients had their radiotherapy plans significantly changed by re-staging scans (11% had metastatic disease and 25% new nodal areas).

Conclusion: