Experience and Outcomes with Hypofractionated Concurrent Chemoradiation for Stage III NSCLC at NCCC Gregory Webb Medical 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:

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 % 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

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