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dc.contributor.authorCoote, Joanna H
dc.contributor.authorTang, C.
dc.contributor.authorSalem, Ahmed
dc.contributor.authorBayman, Neil A
dc.contributor.authorChan, Clara
dc.contributor.authorCobben, David
dc.contributor.authorFaivre-Finn, Corinne
dc.contributor.authorHarris, Maggie A
dc.contributor.authorHudson, Andrew M
dc.contributor.authorPemberton, Laura S
dc.contributor.authorSheikh, Hamid Y
dc.contributor.authorWoolf, David K
dc.date.accessioned2021-01-06T11:15:17Z
dc.date.available2021-01-06T11:15:17Z
dc.date.issued2020en
dc.identifier.citationCoote JH, Tang C, Salem A, Bayman NA, Chan C, Cobben D, et al. Outcomes of curative-intent radiotherapy in patients with severe COPD or lung fibrosis. Lung Cancer. 2020;139:S32-Sen
dc.identifier.urihttp://hdl.handle.net/10541/623586
dc.description.abstractIntroduction: Management of inoperable non-small cell lung cancer (NSCLC) patients with severe chronic obstructive pulmonary disease (COPD) and lung fibrosis is complex. We investigated outcomes of curative-intent radiotherapy in these patients. Methods: 587 NSCLC patients with COPD and 34 with lung fibrosis treated with curative-intent radiotherapy at The Christie NHS Foundation Trust from January 2015 -December 2016 were evaluated. COPD severity was stratified using Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification (GOLD I–IV). Primary end-point was overall-survival (OS). Clinical characteristics, baseline lung function, radiotherapy and dosimetric lung parameters (mean lung dose, V20 and V5 (volume receiving 20 and 5 Gray)) were evaluated for association with OS. Results: 148 (25%) patients received stereotactic ablative body radiotherapy (SABR). Median OS was 21 months (95% confidence interval (CI) 19–23 months), 20 months (95% CI 18-22 months) and 12 months (95% CI 4–18 months) for overall cohort, patients with GOLD III/IV and lung fibrosis respectively. Difference in OS for fibrosis/non-fibrosis patients was significant (p<0.001). FEV1 and GOLD category did not correlate with OS (p≥0.05). Treatment type, tumour volume, dosimetric parameters, tumour stage and histology all correlated with OS; smoking status did not. MRC dyspnoea scores remained stable before (median 4, 95% CI 3–4 and median 4, 95% CI 4–4) and after (median 4, 95% CI 4–5; p≥0.05 and median 4, 95% CI 4–4; p≥0.05) radiotherapy in fibrosis (n=21) and GOLD III/IV patients (n=92), respectively. Oxygen use increased after radiotherapy in GOLD III/IV patients (n=12 vs n=28; p<0.05) but not in fibrosis patients (n=4 vs n=10; p≥0.05). Conclusion: Patients with lung fibrosis have poor OS after radiotherapy. FEV1 is not a good predictor of outcomes after curative-intent radiotherapy. Longer follow up with functional status data would improve understanding of long term outcomes and predictive factors in these patients.en
dc.language.isoenen
dc.titleOutcomes of curative-intent radiotherapy in patients with severe COPD or lung fibrosisen
dc.typeMeetings and Proceedingsen
dc.contributor.departmentThe Christie NHS Foundation Trust, Manchesteren
dc.identifier.journalLung Canceren
dc.description.noteen]


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