2024 World Conference on Lung Cancer (WCLC) - ePosters-EP.07B.06 Transplant Patients with Medically Inoperable Early-Stage Lung Cancer Have Worse Outcomes When Treated with SBRT

EP.07B.06 Transplant Patients with Medically Inoperable Early-Stage Lung Cancer Have Worse Outcomes When Treated with SBRT

Back to course

Pdf Summary

The study evaluates the outcomes of stereotactic body radiotherapy (SBRT) in managing early-stage lung cancer (ES-LC) in patients with solid organ transplants (SOT), who are medically inoperable and chronically immunosuppressed. Chronic immunosuppression in SOT patients elevates their cancer risk, making outcome analysis crucial.<br /><br />Data from 2003 to 2023 in a prospective lung SBRT data registry was surveyed, focusing on the 28 SOT patients out of 1976, constituting 1.4% of the patient population. The median follow-up was 12.4 months. Characteristics of the studied population included a predominance of male patients (52.9%), a median age of 70, and a median smoking history of 34 pack-years.<br /><br />Results showed that 32.1% of the patients experienced toxicity, mostly low grade, but with one Grade 5 pneumonitis case. Patterns of failure revealed a significant distant failure rate (32.1%), with the first site of failure being distant in 50% of cases. Disease-free survival and overall survival medians were 17.1 and 14.5 months, respectively, with metastatic cancer accounting for 25% of the deaths.<br /><br />Univariate analysis identified increased smoking as a predictor for disease failure, whereas multivariate analysis found overall survival to be significantly associated with performance status (KPS) and tumor size. Compared to typical SBRT outcomes for ES-LC, SOT patients displayed higher local failure rates, decreased cancer control, and poorer overall survival. This was hypothesized to relate to immunosuppression promoting understaging, enhanced metastatic progression, and an SBRT-resistant tumor biology in SOT patients.<br /><br />Conclusively, the study highlights impaired outcomes for this patient subset, indicating a need to reconsider SBRT efficacy and explore alternative strategies or tailored approaches in managing SOT patients with ES-LC.

Asset Subtitle

Gregory Videtic

Meta Tag

Speaker Gregory Videtic

Topic Early-Stage Non-small Cell Lung Cancer

Keywords

stereotactic body radiotherapy

early-stage lung cancer

solid organ transplants

chronic immunosuppression

cancer risk

disease-free survival

overall survival

metastatic progression

treatment outcomes

alternative strategies