S815
Clinical - Lung
ESTRO 2026
Digital Poster 3400 Long-term outcomes and patterns of failure after empiric SBRT for presumed early-stage lung tumors Karim El-Marouk 1 , Esra Degerli 1 , Lukas Käsmann 1,2 , Sophie Kröninger 1 , Diego Kauffmann-Guerrero 3,4 , Amanda Tufman 3,4 , Niels Reinmuth 5 , Thomas Duell 5 , Farkhad Manapov 1,6 , Claus Belka 1,2 , Chukwuka Eze 1,3 , Sina Mansoorian 1 1 Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany. 2 German Cancer Research Center (DKFZ), German Cancer Consortium (DKTK), Munich, Germany. 3 German Center for Lung Research (DZL), Comprehensive Pneumology Center, Munich, Germany. 4 Department of Medicine V-Pneumology, University Hospital, LMU Munich, Munich, Germany. 5 Asklepios Kliniken GmbH, Asklepios Fachkliniken Munich, Gauting, Germany. 6 RADIO-LOG Medical, Center for Radiation Therapy, Günzburg, Germany Purpose/Objective: Stereotactic body radiation therapy (SBRT) is the standard for medically inoperable early-stage non- small cell lung cancer (ES-NSCLC). When a biopsy is unfeasible, it is often delivered empirically, yet long- term outcomes and failure patterns remain underreported. Material/Methods: A total of 56 patients with clinically staged T1–T3N0M0 lung tumors treated with empiric SBRT (2011–2022) were retrospectively analyzed. Nineteen patients with recurrence were assessed for failure patterns and survival. Overall survival (OS), progression-free survival (PFS), local failure-free survival (LFFS), regional failure- free survival (RFFS), and distant metastasis-free survival (DMFS) were estimated using the Kaplan– Meier method. Competing risk analysis was performed with death deemed a competing event. Results: At a median follow-up of 80.4 months (95% CI: 65.2– 95.6), 17 patients (30.4%) were alive. Median PFS and OS were 28.5 months (95% CI: 16.4–40.8) and 41.7 months (95% CI: 14.0–69.4), respectively. LFFS was 84.1% at 5 years and 67.3% at 10 years, RFFS was 64.7% at 5 years and 58.8% at 10 years, and DMFS was 62.4% at 5 years and 56.1% at 10 years. Pathologic confirmation of recurrence was obtained in 10 patients, identifying NSCLC in six, small cell lung cancer in three, and urothelial carcinoma in one. Local failures were infrequent and occurred early (median 8.3 months), whereas regional and distant recurrences occurred later (median 13.5 and 22.8 months). At 10 years, the estimated cumulative incidence function was 6.3% for local failure, 14.8% for regional failure, 16.6% for distant failure, and 55.8% for death.
Conclusion: Empiric SBRT provides durable local control in presumed early- stage NSCLC, but outcomes are limited by comorbid mortality and systemic progression. These findings emphasize its effectiveness as a local therapy and the need for prolonged surveillance and systemic strategies. Keywords: SBRT, early-stage NSCLC, patterns of failure Consolidative Thoracic Radiotherapy and Immunotherapy Following Induction Chemo- Immunotherapy in Locally Advanced and Oligometastatic NSCLC Carlo Greco 1,2 , Edy Ippolito 1,2 , Sara Reina 2 , Aurelia Iurato 2 , Marianna Miele 2 , Elisabetta Molfese 2 , Toppi Lucrezia 2 , Michele Fiore 1,2 , Claudia Talocco 2 , Claudia Tacconi 2 , Sara Ramella 1,2 1 Research Unit of Radiation Oncology, Università Campus Bio-Medico di Roma, Rome, Italy. 2 Operative Research Unit of Radiation Oncology, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy Purpose/Objective: Chemotherapy combined with immune checkpoint inhibitors (chemo-immunotherapy) has become the Digital Poster 3467
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