Ahn, S.D.

Choi, E.K.

Jung, I.

Kim, J.H.

Kim, S.S.

Kim, Y.S.

Lee, S.W.

Park, J.H.

Song, S.Y.

Yoon, S.M.

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S586                                                                                                                                                  ESTRO 35 2016 
_____________________________________________________________________________________________________ 
involvement of the esophagus. Without, courses with low 
complications and good local control are possible. 
 
EP-1236  
Does a localized NSCLC treated with SBRT affect the 
survival in COPD patients? 
S. Jeppesen
1Odense University Hospital, Department of Oncology, 
Odense, Denmark 
1,2, N.C.G. Hansen3, T. Schytte1, M. Nielsen4, O. 
Hansen1,2 
2University of Southern Denmark, Institute of Clinical 
Research, Odense, Denmark 
3Odense University Hospital, Department of Respiratory 
Medicine, Odense, Denmark 
4Odense University Hospital, Laboratory of Radiation Physics, 
Odense, Denmark 
 
Purpose or Objective: The most common reason for patients 
(pts) with localized NSCLC to be deemed medical inoperable 
is Chronic Obstructive Pulmonary Disease (COPD). COPD is 
associated with severe morbidity and mortality. It is not 
known if the prognosis of COPD pts is so poor that diagnosed 
localized lung cancer may only have little impact on survival. 
The aim of this study was to compare survival in SBRT treated 
COPD pts unfit for surgery and COPD pts without a malignant 
diagnosis. 
 
Material and Methods: Data for the group of SBRT treated 
NSCLC pts from our institution were prospectively recorded 
from 2007 until 2013. The non-malignant control group was 
retrospectively selected among pts referred to the 
Department of Respiratory Medicine from 2005 until 2011 due 
to suspected lung cancer, which was subsequently ruled out. 
From both groups pts were selected for the present analysis 
if spirometry fulfilled the criteria for COPD defined as the 
ratio between forced expiratory volume in 1 second (FEV1) 
and forced vital capacity (FVC) less than 70%. The COPD was 
classified according to international GOLD criteria as mild, 
moderate, severe, or very severe based on FEV1 in percent of 
predicted (FEV1%pred). Propensity score matching (PSM) was 
performed to reduce confounding between the two groups 
based on age, gender, and FEV1%pred. The treatment 
survival outcome variable was calculated using the Kaplan-
Meier method. Log rank test was used for testing differences 
in survival rates. 
 
Results: 102 SBRT treated pts (NSCLC group) and 573 pts 
without malignant disease (non-malignant group) were 
enrolled after a spirometry revealed COPD. No SBRT-related 
deaths were observed. Pts in the NSCLC group were older 
(p<0.05) and had worse FEV1%pred (p<0.05). PSM identified 
102 pts from each group with similar characteristics: mean 
age of 72.7 years, FEV1%pred of 52, and 54 women. In the 
matched comparison a significant difference in the median 
overall survival was observed, 57 months vs. 87 months in the 
NSCLC and non-malignant groups, respectively p<0.05 (figure 
1). Subgroup analyses of pts with mild/moderate COPD and 
pts with severe/very severe COPD showed that the difference 
in mOS in the unmatched and matched comparison was more 
pronounced in pts with mild/moderate COPD. 
 
 
 
Conclusion: In a matched comparison, SBRT treated COPD 
pts with localized NSCLC had worse survival compared with 
COPD pts without a malignant diagnosis. Despite the serious 
prognosis of COPD, a diagnosis of localized NSCLC affected 
the survival in COPD pts. 
 
EP-1237  
Cyberknife Radiosurgery for spinal metastasis from lung 
cancer 
I. Jung
1Asan Medical Center- Univ of Ulsan, Radiation Oncology, 
Seoul, Korea Republic of 
1, S.Y. Song1, S.D. Ahn1, J.H. Kim1, S.W. Lee1, S.M. 
Yoon1, Y.S. Kim1, J.H. Park1, S.S. Kim1, E.K. Choi1 
 
Purpose or Objective: To evaluate efficacy and safety of 
Cyberknife radiosurgery (CKRS) in patients with spinal 
metastasis from lung cancer. 
 
Material and Methods: From July 2011 to October 2014, 64 
patients received CKRS for spinal metastasis from 
pathologically confirmed lung cancer. Medical record of 75 
lesions in 64 patients retrospectively reviewed. Pain control, 
radiological tumor control, especially epidural mass, and 
treatment related complications such as vertebral 
compression fracture and pain flare were assessed. 
Radiologic response was assessed following RECIST criteria. 
Pain response was defined according to International Bone 
Metastases Consensus Working Party palliative RT endpoints. 
 
Results: Median age of patients with bone metastasis was 61 
years (36-81 years). 42 patients (63.6%) had bone metastasis 
at initial diagnosis. Mean tumor diameter was 2.59 cm (1.2 
cm-8.3cm), and 16 patients had epidural extension. was 
found in 16 patients (21.3%). Radiation dose were 14 – 32 Gy 
per 1-4 fx (BED(α/β=10): 28.8-57.6 Gy, median 41.6 Gy). 
Radiologic evaluation with CT or MR after CKRS was done at 
54 lesions (72.0%). Pain response was assessed in 59 lesions 
(78.7%). With median follow-up of 10.5 months (1 – 40 
months), local tumor progression was found in 9 lesions 
(12.0%), and median time to progression was 10.1 months. 1 
year and 2 year local progression free survival rate was 84.6% 
and 79.7%. Among 16 lesions with epidural extension, 11 
lesions had evaluated by CT or MR, and the tumor regression 
achieved in 8 lesions (72.7%). Pain response rate after CKRS 
was 83.1% (CR : 28.6% , PR : 71.4% , SD : 20.4%). All patients 
tolerated the CKRS course well. Compression fracture was 
found in 31 lesions (41.3%) but only 13 lesions(17.3%) 
collapsed among 54 lesions(72.0%) with osteolysis. 
 
Conclusion: Cyberknife radiosurgery is an effective for local 
control and safe treatment modality to osteolytic spinal 
metastasis from lung cancer. 
 
EP-1238  
Thoracic re-irradiation following curative intent 
radiotherapy for non-small cell lung cancer 
S. Scobie
1Edinburgh Cancer Centre, Clinical Oncology, Edinburgh, 
United Kingdom 
1, G.G. Hanna2, K. Franks3, J. McAleese4, S. Harrow5 
2Centre for Cancer Research and Cell Biology + Northern 
Ireland Cancer Centre, Queen’s University of Belfast + 
Belfast City Hospital, Belfast, United Kingdom 
3St James’s Institute of Oncology, Leeds Cancer Centre, 
Leeds, United Kingdom 
4Northern Ireland Cancer Centre, Belfast City Hospital, 
Belfast, United Kingdom 
5Beatson West of Scotland Cancer Centre, Beatson West of 
Scotland Cancer Centre, Glasgow, United Kingdom 
 
Purpose or Objective: Following curative intent 
radiotherapy, up to 50% of patients with non-small cell lung 
cancer (NSCLC) experience local recurrence. This may be 
associated with significant symptomatology such as airways 
obstruction, haemoptysis and pain. Re-irradiation may be 
useful to palliate symptoms and to attempt cure, but little is 
known about effectiveness, usage rates, techniques used and 
clinical outcome. We report the incidence of thoracic re-
irradiation following curative intent thoracic radiotherapy. 


EP-1237: Cyberknife Radiosurgery for spinal metastasis from lung cancer 

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EP-1237: Cyberknife Radiosurgery for spinal metastasis from lung cancer

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