Lung Cancer |

Stereotactic Body Radiation Therapy (SBRT): Potential Role in Hilar Lung Metastases FREE TO VIEW

Puneet Agarwal, MD; Elizabeth Yogiaveetil, MD; Eric Anderson, MD; Brian Collins, MD; Ismael Matus, MD
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Medstar Georgetown University Hospital, Washington, DC

Chest. 2015;148(4_MeetingAbstracts):590A. doi:10.1378/chest.2279123
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SESSION TITLE: Lung Cancer Treatment Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: To determine safety and efficacy of SBRT in hilar lung metastases, abutting or invading a mainstem bronchus.

METHODS: This is an ongoing retrospective analysis performed at Georgetown University Hospital on a cohort of 20 patients that underwent fiducial-guided SBRT for progressive central thoracic lesion manifesting as a hilar lesion abutting or invading central airway. Patient demographics, subjective (ECOG score) and objective assessments (PFT), CT chest and PET scan for type and degree of central airway obstruction and post SBRT complications were reviewed. Local control and survival rates were also recorded.

RESULTS: Patient’s median age was 68 years. ECOG score was <=1 for all patients. Most of the patients had systemic therapy (80%) prior to SBRT. All patients were inoperable due to advanced stage malignancy. Complications following SBRT included fatigue, grade 2 esophagitis, pulmonary fibrosis and lobar collapse. Local control and overall survival is being reviewed at the time of submission of the abstract but preliminary review indicated excellent local control and median survival duration of over 12 months. 11 patients were noted to have malignant central airway obstruction (MCAO) (5 with >75% and 6 with <25%) prior to therapy. After SBRT, 3 patients showed significant improvement (>50% re-canalization), 3 showed no response, 2 showed progression, and rest were deceased or had no follow up imaging.

CONCLUSIONS: SBRT is safe and effective for hilar lung metastases abutting or invading central airway. Its potential role in MCAO, alone or in combination with therapeutic bronchoscopy warrants further evaluation. Future studies protocolized to assess pre and post-intervention QOL questionnaires (ie. SGRQ) and objective functional studies such as spirometry are needed.

CLINICAL IMPLICATIONS: SBRT is safe and effective for progressive and surgically inoperable malignancies with hilar lung metastases.

DISCLOSURE: The following authors have nothing to disclose: Puneet Agarwal, Elizabeth Yogiaveetil, Eric Anderson, Brian Collins, Ismael Matus

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