ESTRO 36 Abstract Book

S650 ESTRO 36 _______________________________________________________________________________________________

Conclusion Pathologic stage IIIA-N2 NSCLC patients treated with early PORT experienced better OS, LRRFS, and DMFS than those treated with late PORT. Thus, early PORT should be considered as a primary approach for those patients. EP-1201 SLR versus SBRT for high-risk elderly patients with stage I NSCLC H.H. Wang 1 , M.B. Meng 1 , X.L. Zeng 1 , L. Deng 2 1 Tianjin Medical University Cancer Institute & Hospital, Department of Radiation Oncology, , China 2 West China Hospital- West China School of Medicine- Sichuan University, Department of Thoracic Cancer, Tanjin, China Purpose or Objective The purpose of this study was to evaluate the efficacy and safety of radiotherapy (RT) for high-risk elderly patients with stage I non-small cell lung cancer (NSCLC) through a meta-analysis of data from published studies comparing sublobar resection (SLR) with RT including conventional fraction radiation therapy (CFRT) and stereotactic body radiation therapy (SBRT). Material and Methods We searched the Cochrane Library, MEDLINE, CENTRAL, and EMBASE and conducted manual searches. Meta- analysis was performed on the results of homogeneous studies. Analyses subdivided by study design were also performed. Results Based on our search criteria, we found 16 trials involving 11540 patients. Nine were propensity-score matched (PSM) cohort studies, and 7 were cohort studies. Five studies compared SLR with CFRT, and 11 compared SLR with SBRT. Our results showed that SLR, compared with either type of RT, significantly improved the overall survival regardless in both PSM and non-PSM analyses (all p <0.05). However, the pattern of failure after SLR was similar to that after SBRT (all p >0.05). In addition, RT and SLR were associated with specific complications. Conclusion These results demonstrated that SLR treatment of high- risk elderly patients with stage I NSCLC resulted in better overall survival compared with RT, including CFRT and SBRT. Considering the strength of the evidence, additional randomized controlled trials are needed before each treatment modality can be recommended routinely. EP-1202 A lot to a little or a little to a lot - dose- volume relationships in thoracic tumors C. Schröder 1 , R. Engenhart-Cabillic 2 , A. Buchali 3 1 Universität Giessen, Klinik für Strahlentherapie und Radioonkologie- Universitätsklinikum Giessen und Marburg, Giessen, Germany 2 Universität Marburg, Marburg, Germany 3 Ruppiner Kliniken GmbH, Klinik für Strahlentherapie und Radioonkologie, Neuruppin, Germany Purpose or Objective The purpose of this prospective randomized trial was to determine which constellation of dose and corresponding volume of the lung tissue as seen in the dose-volume- histogram (DVH) - either a lot to a little or a little to a lot - should be preferred to ensure the best possible outcome for patients with thoracic carcinomas. To ensure a wider approach we focused on both objective and subjective parameters like clinical outcome, changes in pulmonary function tests (PFT), radiological changes and quality of life (QoL). Material and Methods From 04/12 to 10/15 81 patients with NSCLC, SCLC or esophageal carcinoma were randomized and treated with either a 4-field-IMRT (Arm A) or a VMAT (Arm B) technique.

those undergoing surgery alone; Group 2, comprising those undergoing adjuvant chemotherapy (CT) alone; Group 3, comprising those undergoing adjuvant radiotherapy (RT) alone; Group 4, comprising those receiving adjuvant concurrent chemoradiotherapy; and Group 5, comprising those receiving adjuvant sequential CT and intensity modulation RT. Results We enrolled 588 lung adenoCA (WT EGFR) and squCA patients without distant metastasis. After adjustments for age at surgery, surgical years, and Charlson comorbidity index scores, the multivariate Cox regression analysis demonstrated that adjusted HRs (aHRs; 95% confidence intervals [CIs]) for the overall mortality of female lung adenoCA (WT EGFR) patients were 0.257 (0.111–0.594), 0.530 (0.226–1.243), 0.192 (0.069–0.534), and 0.399 (0.172–0.928) in Groups 2, 3, 4, and 5, respectively. For male lung squCA patients, the aHRs (95% CIs) for overall mortality were 0.269 (0.160–0.451), 0.802 (0.458–1.327), 0.597 (0.358–0.998), and 0.456 (0.265–0.783) in Groups 2, 3, 4, and 5, respectively. Conclusion Adjuvant CCRT or sequential CT and IMRT ≥5000 cGy significantly reduced the mortality rate of female lung adenoCA (WT EGFR) and male squCA pN2 patients. EP-1200 Early versus late PORT for pathologic stage IIIA-N2 NSCLC: a multi-institutional retrospective study M.B. Meng 1 , H.H. Wang 1 , L. Deng 2 , Q.L. Wen 3 , C.Z. Zhang 4 , X.L. Zeng 1 , Y.L. Cui 5 , Z.Y. Yuan 1 , P. Wang 1 1 Tianjin Medical University Cancer Institute & Hospital, Department of Radiation Oncology, tianjin, China 2 West China Hospital- West China of Medical School- Sichuan University, Department of Thoracic Cancer, Chengdu, China 3 Affiliated Hospital of Southwest Medical University, Department of Oncology, Luzhou, China 4 Nankai University Tianjin People’s Hospital, Department of Surgery, Tianjin, China 5 Tianjin Medical University Cancer Institute & Hospital, Department of Lymphoma, tianjin, China Purpose or Objective The aim of this study was to evaluate the effect of the time of postoperative radiotherapy (PORT) in combined modality treatment for pathologic stage IIIA-N2 non-small cell lung cancer (NSCLC). Material and Methods Between January 2008 and December 2015, patients with pathologic stage IIIA-N2 NSCLC were enrolled and treated with PORT concurrent with or sequential to fewer than three cycles of postoperative chemotherapy (POCT, early PORT) or with PORT administered after at least four cycles of POCT (late PORT) at multiple hospitals. The primary end point was overall survival (OS); secondary end points included pattern of the first failure, locoregional recurrence-free survival (LRRFS), and distant metastasis- free survival (DMFS). Kaplan–Meier OS, LRRFS, and DMFS curves were compared with the log-rank test. Cox regression analysis was used to determine prognosticators for OS, LRRFS, and DMFS. Results Of 112 included patients, 41 (36.61%) and 71 (63.39%) patients received early PORT and late PORT, respectively. The median OS, LRRFS, and DMFS were longer for those who received early PORT than for those who received late PORT at the median follow-up of 29.6 months (all p < 0.05). Uni- and multi-variate analyses showed that number of POCT cycles and the combination schedule of PORT and POCT were independent prognostic factors for OS, LRRFS, and DMFS.