What proportion of patients with stage I NSCLC seen in the oncology clinic are treated with SABR?
Brennan, E. Garbett, A. Hoey, P. Cobben, David Chan, Clara Coote, Joanna H Faivre-Finn, Corinne Harris, Maggie A Hudson, Andrew M Pemberton, Laura S
Brennan, E.
Garbett, A.
Hoey, P.
Cobben, David
Chan, Clara
Coote, Joanna H
Faivre-Finn, Corinne
Harris, Maggie A
Hudson, Andrew M
Pemberton, Laura S
Citations
Altmetric:
Abstract
Introduction: Stereotactic radiotherapy (SABR) is standard of
care for inoperable stage I NSCLC. The proportion of patients with
stage I NSCLC treated with SABR is a lung cancer quality measure
at this cancer centre and is < 50%. This retrospective analysis aims
to validate the accuracy of this quality measure, and explores the
reasons why patients did not receive SABR.
Methods: Electronic patient records (EPR) were reviewed for all
patients with stage I NSCLC first seen in the oncology clinics between
01/06/2018 and 31/12/2018.
Results: Of the 119 patients with stage I (T1a=17; T1b=56; T1c=3;
T2a=43; T2b=0) disease, 54 (45.4%) had biopsy proven NSCLC (20
squamous; 34 non-squamous). Median ECOG performance status
(PS) was 2 (PS 0=6; PS 1=38, PS 2=42, PS 3=33). The lung cancer MDT
referred 45 (37.8%) of these patients for surgical assessment also. 87
(73.1%) patients received radiotherapy, 15 (12.6%) received surgery,
and 17 (14.3%) did not receive active treatment. SABR was delivered
to 52 (43.7%) of patients (54Gy/3 fractions(F)=6, 60Gy/5F=40,
60Gy/8F=6), 9 received 60Gy/15F, and 28 received 55Gy/20F.
For the 52 non-surgical patients not treated with SABR, 39 had a
justification for this decision recorded in the EPR, including tumour
too close to organs at risk (OAR) (proximal bronchial tree (5), heart/
great vessels (2), spinal cord (6)), treatment volume too large (4), PS/
co-morbidities (10), and patient choice (6).
Conclusion: Whilst <50% of all patients with stage 1 NSCLC seen in
the oncology clinic received SABR, >70% treated with radiotherapy
received SABR or an accelerated hypofractionated regimen
(60Gy/15F). The most common reason for not offering SABR was
vicinity of tumour to OAR. Latest UK SABR Consortium guidance on
treating central tumours could increase the proportion of patients
treated with SABR.
Affiliation
Description
Date
2020
Publisher
Collections
Keywords
Type
Meetings and Proceedings
Citation
Brennan E, Garbett A, Hoey P, Cobben D, Chan C, Coote JH, et al. What proportion of patients with stage I NSCLC seen in the oncology clinic are treated with SABR? Lung Cancer. 2020;139:S32-S