Lung Cancer

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TU_27_3586 - Outcomes of Stereotactic Ablative Radiation Therapy for Presumed Early-Stage Lung Cancer: Three-Year Results in a 119 Patient Cohort.

Tuesday, October 23
2:45 PM - 4:15 PM
Location: Innovation Hub, Exhibit Hall 3

Outcomes of Stereotactic Ablative Radiation Therapy for Presumed Early-Stage Lung Cancer: Three-Year Results in a 119 Patient Cohort.
A. Dautruche1, E. Filion1, D. Mathieu2, D. Roberge3, L. Lambert1, T. Vu2, and M. P. Campeau2; 1Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada, 2Centre hospitalier de l'Universite de Montreal, Montreal, QC, Canada, 3Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, QC, Canada

Purpose/Objective(s): For non-operable stage I non-small cell lung cancer (NSCLC), Stereotactic ablative radiotherapy (SABR) has emerged as a standard treatment option. However, in some cases obtaining pathological confirmation is not feasible due to either a patient’s comorbidities or preference. We aimed to assess clinical outcomes among patients who received SABR for a pulmonary mass without tissue diagnosis.

Materials/Methods: Eligible patients presented with a pulmonary mass and a strong clinical suspicion of lung cancer. Patients were either not eligible for a biopsy or had an inconclusive biopsy. All patients had a PET-CT showing hypermetabolism, and documented growth of the mass. Patients had either significant comorbidity that precluded lobectomy, or refused surgery. We included masses that would have been clinically staged T1 or T2, N0, M0. The primary endpoint was progression-free survival (PFS). Secondary endpoint were overall survival (OS), local control (LC), regional control (RC) and distant metastasis-free survival (DMFS), evaluated by Kaplan-Meier analysis.

Results: A total of 931 lung SABR treatments were performed, on 878 patients from July 2009 to July 2017. Within this population 119 patients met our inclusion criteria. The median age of the patients was 74 years, and the median follow-up was 3.9 years (range 0.3 – 7 years). Median SUV of treated tumors was 4.9 (range 1.6 – 15.9). Estimated 3-year overall survival and PFS were 65% and 55%, respectively. Estimated local control, regional control and metastasis-free survival at 3 years were 93%, 93% and 85%. Five patients (4%) presented grade 3 treatment-related adverse-events, and one a grade 4 adverse event. There were no reported grade 5 adverse events.

Conclusion: With a median follow-up of almost 4 years, we have found that SABR is both feasible and well tolerated in this fragile population for localized, non-pathologically proven, neoplastic lung disease.

Author Disclosure: A. Dautruche: None. E. Filion: None. D. Mathieu: None. D. Roberge: Honoraria; BrainLab, Siemens Medical Systems, Varian Medical Systems. In-kind Donation; Accuray. Head of Radiation Oncology; Centre Hospitalier de l'Université de Montréal. T. Vu: None.

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