Experience and Outcomes with Hypofractionated

Concurrent Chemoradiation for Stage III NSCLC at NCCC

Gregory WebbMedical Student

Background

Standard treatment for stage III NSCLC involves bimodality therapy: Sequential Concurrent

Auperin et al. confirmed an overall and progression-free survival benefit using concurrent chemoradiotherapy J Clin Oncol 2010; 28:2181-2190.

Audit objectives

1. To assess the overall and progression-free survival of patients with stage III NSCLC treated with concurrent therapy at NCCC

2. To assess whether the NCCC can provide safe and effective concurrent treatment for stage III NSCLC patients by comparing NCCC outcomes with those of the meta-analysis

Methods

Patient sample – NCCC

Five year period (Jan ’05 – Dec’09)

Data sources – Department database and case notes

Retrospective analysis of cohort

Patient characteristics

Sample size – 21

Average age – 59

M:F – 14:7

Performance status 17 patients had a PS 0/1 4 patients did not have their PS recorded on diagnosis

Treatment

Chemotherapy regimen – Vinorelbine-Cisplatin

Radiotherapy - 55Gy in 20 fractions

86% of patients completed their chemotherapy regimen

Results – survival data

Median overall survival – 19 months

Median progression-free survival – 16 months

Number of patients alive to date – 8/21 (38.1%)

Number of patients alive to date disease free – 5/21 (23.8%)

Survival curve - Overall survival

•One year overall survival – 76.2%•Two year overall survival - 39.8%•Three year overall survival – 36.7%•Five year overall survival – 36.7%

Survival curve - Progression-free survival

•One year progression-free survival – 57.1%•Two year progression-free survival – 26.2%•Three year progression-free survival – 23.8%•Five year progression-free survival – 23.8%

Results - comparison

NCCC Overall survival

1 year – 76.2% 3 year – 36.7% 5 year – 36.7%

Progression-free survival 1 year – 57.1% 3 year – 23.8% 5 year – 23.8%

Meta-analysis Overall survival

1 year - NA 3 year – 23.8% 5 year – 15.1%

Progression-free survival 1 year – 40.5% 3 year – 16.0% 5 year – 11.6%

Conclusions

NCCC can provide safe and effective concurrent chemoradiotherapy for patients diagnosed with stage III NSCLC

NCCC aiming at service development For all patients with Stage III NSCLC PS0-1; good renal function Standard concurrent chemoradiotherapy with

Vinolrebine-Cisplatin

QUESTIONS?Thank you for listening