SBRT for oligoprogressive/oligorecurrent SCLC: is it worth it?
PO-1272
Abstract
SBRT for oligoprogressive/oligorecurrent SCLC: is it worth it?
Authors: Antonin Levy1, Angela Botticella2, Elisabeth Cohen-Jonathan Moyal3, Carole Massabeau4, Cécile Le Péchoux2, Jonathan Khalifa5
1Gustave Roussy, Radiation Oncology, Villejuif, France; 2Gudtave Roussy, Radiation Oncology, Villejuif, France; 3Institut Claudius Regaud/Institut Universitaire du Cancer de Toulouse , Radiation Oncology, Toulouse, France; 4Institut Claudius Regaud/Institut Universitaire du Cancer de Toulouse, Radiation Oncology , Toulouse, France; 5Institut Claudius Regaud/Institut Universitaire du Cancer de Toulouse, Radiation Oncology , Radiation Oncology , Toulouse, France
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Purpose or Objective
The role of local
ablative treatments, including stereotactic body radiotherapy (SBRT), is an
area of active research in oligometastatic non-small cell lung cancer patients.
Small cell lung cancer (SCLC) has a poor prognosis, with common diffuse
metastatic evolution.
We evaluated
the outcomes after SBRT in rare cases of oligoprogressive / oligorecurrent SCLC
patients.
Material and Methods
The data of SCLC patients who received SBRT for
oligoprogressive / oligorecurrent
disease in two French centers were retrospectively analyzed. Synchronous
oligometastatic disease, SBRT for primary lung tumor and brain radiosurgery
patients were not included in this analysis. Relapse and survival rates were defined as the time
between the date of SBRT and the first event.
Results
Thirteen
patients (male, 69%; n=7/13, all with initially limited stage), presenting 17
lesions were identified. All patients received prior treatments (thoracic
chemoradiotherapy [n=7/13] and/or chemotherapy [n=6/13; median number of one
line, range, 0-2 lines; only one received immunotherapy]) and the median ECOG
PS was 1 (n=11/13). The main type of presentation was metachronous
oligometastatic disease (n=10; vs 3 oligoprogression) and occurred at a median
of 17.2 months after initial diagnosis. SBRT was delivered to one (n=9) to two (n=4)
lesions (median size, 22 mm [range, 7-44 mm]) at a median dose of 48 Gy (range,
30-55 Gy) in 5 fractions (range, 5-10 fractions), mainly to lung [n=13/17]
metastases. At a median follow-up of 3.2 years, no local relapse was observed but
most (n=10) experienced distant relapse (DR). The median DR and overall
survival rates were 3.6 months [95%CI:
2.5-13.7 months] and 12.6 months [95%CI: 7.5-29.9 months], respectively. The
was no severe observed SBRT-related toxicities.
Conclusion
Prognosis was
poor, with DR occurring in most patients. However, local control was excellent and long term response after SBRT may
occur in oligoprogressive / oligorecurrent SCLC. Local
ablative treatments should be discussed in a multidisciplinary setting on well-selected cases.