J. Harney

P3.16-18 Modern Radiotherapy Increases Patient Access to Curative Intent Radiotherapy in Non-Small Cell Lung Cancer

Background: The authors evaluated the efficacy, patterns of failure, toxicity and cost of body gamma-ray stereotactic ablative radiotherapy (Body Gamma-ray SABR) for patients with medically inoperable, clinical stage I/II non-small cell lung cancer (NSCLC) with 8 years of follow-up. Clinical staging was performed according to the sixth edition of the American Joint Committee on Cancer TNM staging system. Method: Eligible patients who had no previous treatments, with histologically confirmed NSCLC, determined as clinical stage I /II, underwent OUR-QGD type of the body gamma-ray SABR (70 grays in 10 fractions for gross target volume) at the Radiation Oncology Department, People’s Liberation Army Airforce General Hospital, Beijing, China from January 2007 to July 2010. All patients were immobilized by vacuum bag, and then a slow CT scan was performed without any respiration gating. The total radiation dose of 50%, 60%, and 70% isodose line were prescribed in 50, 60, and 70 Grey (Gy) correspondingly, covering 100% of the planning target volume (PTV), 90% of the clinical target volume (CTV), and 80% of the gross target volume (GTV) in 10 fractions. The CT scan and/or positron emission tomography/ computed tomography were every 3 months for the first 2 years, every 6 months for the next 3 years, and then annually thereafter to evaluate the efficacy of the treatment. The primary endpoint was overall survival. Result: A total of 29 patients were eligible for analysis. The median age of the patients was 71 years (55-87), and the median follow-up was 8.1 years (6.8-10.3). The 1-year, 3-year, 5-year and 8year overall survival rates were 93.1%, 72.1%, 59.4% and 44.8%, and the local, regional and distant disease recurrence were 10.3%, 13.8% and 13.8% at 5 years and 10.3%, 17.2% and 20.7% at 8 years. Two patients (6.9%) experienced grade 3 treatment-related adverse events. No patients developed grade 4 or 5 adverse events. The median cost of body gamma-ray SABR is 4838 dollars (4615-4923 dollars). Conclusion: With long-term follow-up, the results of the current study demonstrated outstanding local control and low toxicity after body gamma-ray SABR in patients with clinical stage I/II NSCLC. The dominant failure included regional and distant disease recurrence. And the body Gamma-ray SABR is pretty cost-effective.

Single institution, retrospective comparison of toxicity and outcome for static 5-field IMRT versus VMAT in the delivery of prostate and pelvic nodal irradiation in high-risk prostate cancer.

147 Background: There is emerging evidence for the role of pelvic nodal irradiation in high-risk prostate cancer. We have assessed the toxicity rates and outcomes with 2 different radiotherapy techniques. Methods: The baseline disease metrics, toxicity and outcome data for men treated at our institution with prostate and pelvic nodal irradiation during a 2 year period were retrospectively collected. The radiotherapy technique, either 5-field IMRT or VMAT was recorded along with a single dose-level to indicate normal tissue exposure (V50 to bowel and rectum, that is the percentage of total organ receiving ≥ 50Gy). Results: 67 men with a median age of 64 years were identified; 83.6% were Gleason ≥ 8, 82.1% were ≥ T3a, 50.7% were N1, 4.5% were M1a/M1b. All had neoadjuvant and concurrent hormone therapy. All received 74Gy to prostate; 70.1% received 60Gy to pelvic nodes, 28.4% received 55Gy to pelvic nodes (1 patient received 56Gy). 55.2% were treated with static IMRT and 44.8% with VMAT with no significant d...