Caglar, Hale Basak

Koylu, Murat

Sert, Fatma

Yalman, Deniz

Journal of Thoracic Oncology

WOS: 000413055802261Background: To investigate the current status of radiotherapy (RT) trends in the definitive treatment of lung cancer in Turkey. Methods: A questionnaire consisting of 46 questions about the technical facilities, and indications regarding the definitive radiotherapy of lung cancer was sent to 62 centers in Turkey, and was answered by 47 centers

Köylü, Murat

Çağlar, Hale Başak

İstanbul Medipol University Institutional Repository

S1036 Journal of Thoracic Oncology Vol. 12 No. 1Stumor and mediastinum and a boost of 20Gy to all grossdisease. All patients also received platinum baseddoublet regimen concurrently. After CRT, the patientswere re-evaluated in the resectability and underwentsurgery. We analyzed tumor volume reduction ratio nearthe end of radiation therapy. All patients were classifiedby their lung condition about emphysematous andinterstitial changes with CT images before treatment intothree degree (slight / moderate / severe). Patients withgrade 2 or worse RP were ebaluated with their Dose-Volume Histofram(DVH) parameteres of both lungs.Results: Themedian follow up timewas 73.9months. The3-year and 5-year overall survival rates were 44.8% and33.0% in all patients, and 74.7% and 64.7% in patientswith CRT followed by surgery. The 3-year and 5-year localcontrol rates were 68.8% and 49.0%, respectively, in allpatients. More than 50 % volume reduction was observedin 73.2 % of patients surviving over 2-years, but 32.3% ofthese good responder had local failure. Grade 2 or worseRP were observed in 70 patients (27%), grade3 in 11patients (4%), grade 5 in 3 patients (1%). The median ofV5Gy, V10Gy, V20Gy, V40Gy, andmean dose of groupwithgrade 2 or worse RP were 32.1, 27.5, 22.5, 16.5 %, and13.5Gy, respectively, and with grade 3 to 5 RP were 31.5,27.9, 23.9, 19.0 %, and 12.8Gy, respectively. In patientswith grade 3 to 5 RP, 8 of 14 patients had severeemphysematous lung and moderate or severe interstitialchange, or had over 30 % lung V20Gy.Conclusion: CRT for stage III NSCLC was effective withacceptable toxicities. Even though patients had goodearly response to CRT, local control was not sufficient.Grade 3 or worse RP may relate not only to DVH pa-rameters, but also pulmonary complication before CRT.Keywords: CRT, lung cancerP2.05-010Stereotactic Radioterapy (SBRT) forPrimary and Metastatic Lung Tumors inElderly PatientsTopic: Clinical OutcomeLuis Larrea,1 Enrique López,2 Paola Antonini,2Verónica González,2 José Bea,2 Macarmen Baños,2Maángeles García2 1Radiation Oncology, Hospital NisaVirgen Del Consuelo, Valencia/Spain, 2Hospital NisaVirgen Del Consuelo, Valencia/SpainBackground: To evaluate SBRT for primary and meta-static lung tumors in elderly patients.Methods: Retrospective analysis of technique and re-sults of SBRT for lung tumors in patients over 75 yearsold treated in a single institution.Simulationwasmadewith CT, abdominal compression andstereotactic frame. Internal target volume (ITV) wascovered according ICRU recommendations. Treatmentdelivery using planar or noncoplanar fields or VMAT-IMRTdynamic arc. The prescribed dose was either 3 fractions of15Gy each or a single 30Gy fraction. Planar images or conebeamCTwere used for verification. Toxicity and radiologicresponsewere assessed using standardized criteria (RTOGand RECIST). Survival rates and toxicities were calculatedby the Kaplan-Meier method.Results: Between 2002 and 2015, 86 patients had 103SBRT procedures; of those 66 were for primary lung tu-mors (T1-2N0M0) and to 37oligometastases (M1).Medianpatient age was 80 years (75-88). At the treatment all pa-tients had good performance status (ECOG PS 0-1). TheFEV1was over 30% of predicted. 10% of the primary and67% of the M1 received systemic treatment before SBRT.73%of the patients had 18-FDG PET-CT previous to SBRT.Primary tumors histology included: 48% epidermoid, 14%adenocarcinoma, 19% undifferentiated, 4% neuroendo-crine and 15% PET positive tumors without histology. Inlung M1 patients the origin was in: 53% NSCLC, 24%colorectal adenocarcinoma, 8.5% urotelial tumors, 8.5%thyroid, 3% endometrial and 3% parotid. Median ITV was11.6 cm3 (0.9-143). Biological Equivalent Dose BED >100Gy. Transient grade 1 or 2 acute toxicities (cutaneouserythema, esophagitis, rib pain or respiratory symptoms)occurred in 11%. No grade > 3 acute or any chronic tox-icitieswere identified.Median follow-up22months (4-65).Overall survival is 79.4 % at 1 year (78.7 % primary; 81%M1) and 74.2% at 2 years (65.9% primary; 84.6% M1).Global cancer-specific survival rates were: 80.5 % (78.8 %primary and 84.6% M1). Local control in the irradiatedvolume is 97.2% in primary and 100% in M1 tumors, theonly failure was marginal/proximal, in a patient withneuroendocrine histology, rescuedwith second time SBRT.Conclusion: SBRT is an excellent treatment option forlung tumors and metastasis in elderly patients in whomother treatment options might be limited. Our encour-aging results are similar or better than those reportedfor younger patients.Keywords: stereotactic, radiation, elderly, tumorP2.05-011The Current Status of Radiotherapy inthe Definitive Treatment of Lung Cancerin a Developing Country: TurkeyTopic: Clinical OutcomeDeniz Yalman,1 Murat Koylu,1 Fatma Sert,1Hale Basak Caglar2 1Dept. Radiation Oncology, EgeJanuary 2017 Abstracts S1037University Faculty of Medicine, Izmir/Turkey, 2Dept.Radiation Oncology, Medipol University, Istanbul/TurkeyBackground: To investigate the current status ofradiotherapy (RT) trends in the definitive treatment oflung cancer in Turkey.Methods: A questionnaire consisting of 46 questionsabout the technical facilities, and indications regardingthe definitive radiotherapy of lung cancer was sent to 62centers in Turkey, and was answered by 47 centers.Results: RT centers were mostly gathered in Marmara,Central Anatolia, and Aegean region (15, 12 and 8 centersrespectively). The median number of patients with non-small cell (NSCLC) and small-cell lung cancer (SCLC) treateddefinitively in one year were 55 and 15 respectively. Thecases are discussed in a multidisciplinary tumor board in75% of the centers. All of the centers use at least the mini-mum technological standard which is CT-planned 3Dconformal RT (3D-CRT) in the definitive treatment of lungcancer; 33%has 4D-CT simulation facility, 94%use PET/CTin RT planning, 75% apply RT under image guidance; 41%has stereotactic body radiotherapy (SBRT) facility, and 53%use SBRT routinely in early-stage NSCLC patients who aremedically inoperable or who refuse surgery. Ninety-eightpercent of the centers apply concurrent chemoRT (87%starting RT with the first chemotherapy course) in locallyadvanced NSCLC. Concurrent chemoRT dose is 60-66 Gy in96%. Chemotherapy was given by the radiation oncologistsin 34% of the centers. In stage IIIA (N2) potentially resect-able disease 56% of the centers apply neoadjuvant treat-ment (chemoRT 67%, chemo 33%). Besides mainpostoperative RT indications 27%of the centers apply RT topatients with inadequate mediastinal dissection, 37% applyto patients with suboptimal surgery. Regarding definitivetreatment of SCLC 17% of the centers apply 45 Gy bid, 50%apply 50-60 Gy, 28% apply 61-66 Gy concurrent withcisplatin-etoposide, starting with the first or second coursein 87%. In extensive-stage SCLC 89% of the centers applythoracic RT (50-66 Gy in 62%, 30 Gy in 26%) after chemo-therapy. Prophylactic cranial irradiationdoseswere 25Gy in71%, 30 Gy in 22%. The patients are followedwith 3-monthintervals in 89% of the centers, however there is noconsensus regarding follow-up workup among the centers.Conclusion: At least minimum world standards can beapplied in the definitive RT of lung cancer in Turkey. Theproblems regarding optimal RT dose and fractionationand concurrent chemotherapy regimen, postoperativeRT indications are similar, but as a developing countrywe need more multidisciplinary workup and develop ourown guidelines taking into account our own resourcesand patient characteristics.Keywords: lung cancer, definitive radiotherapy, Devel-oping CountryP2.05-012Definitive Radiotherapy and Survival inLung Cancer: Results from a BrazilianCohort StudyTopic: Clinical OutcomeMatheus Leal,1 Juliano Cé Coelho,2 Fábio Klamt,3Mariane Araujo Branco,4 Manuela Zereu51Bioquimica, Ufrgs, Porto Alegre/Brazil, 2MedicalOncology, Hospital de Clínicas de Porto Alegre, PortoAlegre/Brazil, 3Biochemistry, Universidade Federal Do RioGrande Do Sul, Porto Alegre/Brazil, 4Ufrgs, Porto Alegre/Brazil, 5Iscmpa, Porto Alegre/BrazilBackground: Lung Cancer is a major cause of cancermortality around the world. Many patients are not fit forsurgery or chemoradiation, and are treated with radia-tion therapy alone. There are few data on the outcomesof definitive radiotherapy in Brazil.Methods: All patients AJCC I-III Stage undergoingdefinitive radiotherapy at the HCPA between 2010 and2015 were assessed. Only individuals unfit for chemo-therapy were evaluated. We excluded patients thatreceived surgery. All patients were treated withconformal radiotherapy (3DCRT) and curative intentIndividual variables and outcomes were retrospectivelyevaluated through medical records Statistical analysiswas performed with software SPSS 22.Results:Patient characteristics N ¼ 68 (%)Age, (Mean) 60,22 yearsGender, No. (%) Men Women 43 (63,2%) 25 (36,7%)Race, No (%) White 54 (79,4%)AJCC stage, No (%) I II III 5 (7,3%) 26 (38,2%) 37 (54,4%)PS ECOG, No (%) 0-2 3-4 44(64,7%) 24 (35,3%)Between 2010 and 2015, 68 patients were treated withradiation therapy alone. Most of patients were male and

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The current status of radiotherapy in the definitive treatment of lung cancer in a developing country: Turkey

The Current Status of Radiotherapy in the Definitive Treatment of Lung Cancer in a Developing Country: Turkey

The Current Status of Radiotherapy in the Definitive Treatment of Lung Cancer in a Developing Country: Turkey

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