ESTRO 2025 - Abstract Book

S1379

Clinical - Lung

ESTRO 2025

improved ECOG performance (76.1% ECOG 0-1 in 2021 vs. 65.4% in 2019, p = 0.0411). Referral-to-diagnosis times significantly enhanced during the pandemic, with median intervals reducing from 19 days in 2019 to 14 days in 2020/2021 (p < 0.0001). While the time to treatment initiation remained stable (median 33–35 days), delays in surgical interventions persisted, exceeding 76 days in 2021. The proportion of early-stage diagnoses increased from 15.6% in 2019 to 18% in 2021, while advanced-stage diagnoses decreased from 68.7% in 2019 to 56.3% in 2021. One-year survival improved during the pandemic: 37% (95% CI: 30–45%) in 2019 to 43% (95% CI: 36–52%) in 2020 and 2021. Two-year survival also increased, from 22% (95% CI: 16–29%) in 2019 to 27% (95% CI: 21–36%) in 2020 and 30% (95% CI: 24–37%) in 2021 ( Figure 2 ). Multivariate analysis showed that advanced-stage disease (HR = 6.98, p < 0.001) and poor ECOG performance status (HR = 3.45, p < 0.001) were strong predictors of mortality. Conclusion: The COVID-19 pandemic improved diagnostic efficiency, reflected in better 1-year and 2-year survival rates. However, delays in surgical interventions persisted, affecting outcomes for curative cases. Advanced-stage disease and poor ECOG performance remained key mortality predictors. Prioritizing timely treatments and enhancing care pathways are critical for resilience in future crises. References: 1- Bouza E, Martin M, Alés JE, et al. Impact of the COVID-19 pandemic on the diagnosis and treatment of onco hematologic patients: a discussion paper. Rev Esp Quimioter. 2023 Feb;36(1):1-25. doi: 10.37201/req/087.2022. PMID: 36322133; PMCID: PMC9910677. 2- Conibear J, Nossiter J, Foster C, et al. The National Lung Cancer Audit: The Impact of COVID-19. Clin Oncol (R Coll Radiol). 2022 Nov;34(11):701-707. doi: 10.1016/j.clon.2022.09.002. PMID: 36180356; PMCID: PMC9474418. 3- Ocanto A, Mielgo-Rubio X, Luna Tirado J, et al. Coronavirus disease 2019 and lung cancer: where are we? Explor Target Antitumor Ther. 2023;4(5):1082-1094. doi: 10.37349/etat.2023.00182. PMID: 38023992; PMCID: PMC10651354. Proffered Paper Highly Hypofractionated versus Standard Tumor Irradiation in Locally Advanced NSCLC with Durvalumab Maintenance: A Multicenter Retrospective Study Etienne CEDOZ 1 , Antonin LEVY 2 , Isabelle MARTEL-LAFAY 1 , Pierre-Yves BONDIAU 3 , Cécile LE PECHOUX 2 , Christos CHOUAID 4 , Myriam AYADI-ZAHRA 1 , Jérôme DOYEN 3 , Benoit ALLIGNET 1 1 Radiation Oncology, Centre Léon Bérard, Lyon, France. 2 Radiation Oncology, Gustave Roussy, Villejuif, France. 3 Radiation Oncology, Centre Antoine Lacassagne, Nice, France. 4 Pneumology, Centre Hospitalier Intercommunal de Créteil, Créteil, France Purpose/Objective: Promising results were reported using stereotactic body radiotherapy (SBRT) in locally advanced non-small cell lung cancer (LANSCLC) (1-3). Nevertheless, data remain scarce, usually published before durvalumab era and without control group. This study evaluates the interest of adding tumor SBRT to standard PACIFIC-regimen in LANSCLC. Material/Methods: This retrospective multicenter (n=3) study included patients with unresectable LANSCLC treated between July 2017 and January 2023. Eligible patients were adult, with stage II–III NSCLC deemed unresectable or unsuitable for surgery, received ≥60 Gy normofractionated radiotherapy (NFRT), ≥1 cycle of concurrent or sequential platinum based chemotherapy, and ≥1 cycle of durvalumab. SBRT group included patients that received mediastinal NFRT and highly hypofractionated primary tumor irradiation, defined as <10 fractions of ≥5 Gy. A propensity score Keywords: COVID-19, wait times, lung cancer survival 2992