2. Conflict of Interest Declaration: Nothing to Disclose Presenter: Sophie Lamoureux Title of Presentation: A Comparison of Stereotactic Body Radiotherapy with Hypofractionated Radiotherapy for Early Stage Non-small Cell Lung Cancer: Control Rates from a Regional Cancer Centre I have no financial or personal relationships to disclose

7. Technologies: - Four Dimensional CT Simulation - Integrated PET planning - Conformal Radiation Therapy - On board Cone Beam CT

24. 45 pts

25. NECC SABR - 48Gy in 4 fractions - VMAT Planning - SABR Tumor Board - Patient Selection Medically inoperable T1 or T2 <5cm Biopsy proven or suspected NSCLCa

26. NECC SABR Database Baseline demographics T Stage Size Biopsy results PET results PFT Dosimetry

27. NECC SABR Database Follow up data – q3mos initially Performance Status Survival / Cause of death Lesional control Regional control Distant control

28. NECC SABR Database Follow up data – CTCAE 4.02 Chest wall pain Esophagitis Pneumonitis Pulmonary Hemorrhage

29. Patients - 54 Patients were treated with 4800/12 - 26 Patients were treated with 5200/13 - 28 Patients were treated with 6000/15 - 76 Patients were treated with SABR of which 33 were peripheral lesions treated with 4800/4 Central lesions treated with 6000/8 were not analysed. Metastatic lesions are not included in this analysis.

30. Hypofractionation Toxicity No Data collected

31. SABR Toxicity Symptomatic Pneumonitis 0 Pulmonary Hemmorhage0 Symptomatic Chest Wall Pain1 Symptomatic Esophagitis0 33 evaluable patients, Median follow up 245 Days

32. NECC Hypofractionated Demographics Table 1. Demographics of early stage lung cancer patients treated with hypofractionated RT at the NECC CharacteristicValue No. of patients108 Median age (in years)80 (56-99) Status Alive43.5% Deceased56.5% Gender Female40.7% Male59.3% Median diameter (in cm)2.95 (1.0-7.3) Dose (in cGy)/fraction 4800/1250.0% 5200/1324.1% 6000/1525.9% PET Scan Yes46.1% No53.9% Bone Scan Yes63.7% No36.3% CT Head Yes63.7% No36.3% MRI Head Yes6.9% No93.1%

33. Overall Survival (Hypofraction) (days)

34. Lesional Control (Hypofraction) (days)

35. Regional Disease (Hypofraction)

36. Metastatic Disease (Hypofraction) (days)

37. Regional Disease (Hypofraction) (days)

38. Metastatic Disease (Hypofraction) (days)

39. Overall Survival (days)

40. Lesional Control (days)

41. Conclusion Radiotherapy for early stage lung cancer has advanced significantly at NECC. As of Feb 2015, over 76 SABR treatments have been delivered and 108 hypofractionated radiotherapy treatments. There is a non-significant trend towards improved lesional control with higher doses of RT with no change in regional control, development of metastatic disease, survival or toxicity.