Experience and Outcomes with Hypofractionated Concurrent Chemoradiation for Stage III NSCLC at NCCC

1
Experience and Outcomes with Hypofractionated
Concurrent Chemoradiation for Stage III NSCLC at
NCCC

• Gregory Webb
• Medical Student

2
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 282181-2190.

3
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

4
Methods

• Patient sample NCCC
• Five year period (Jan 05 Dec09)
• Data sources Department database and case notes
• Retrospective analysis of cohort

5
Patient characteristics

• Sample size 21
• Average age 59
• MF 147
• Performance status
• 17 patients had a PS 0/1
• 4 patients did not have their PS recorded on
  diagnosis

6
Treatment

• Chemotherapy regimen Vinorelbine-Cisplatin
• Radiotherapy - 55Gy in 20 fractions
• 86 of patients completed their chemotherapy
  regimen

7
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)

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

9
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

10
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

11
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

12
Questions?

• Thank you for listening