S827
Clinical - Lung
ESTRO 2026
Cancer Centre, Melbourne, Australia. 6 Clinical Trials Unit, Peter MacCallum Cancer Centre, Melbourne, Australia
nodal involvement and lower lymphocyte count were associated with worse OS (Table 2). In multivariable analysis, sex and stage were significant for PFS (HR 2.3[1.1-5.2], p = 0.038 and HR 1.5[1.1-2.2], p = 0.034, respectively), while nodal involvement and lymphocyte count remained significant for OS (HR 2.1[1.2-3.4], p = 0.005 and HR 4.2[1.9-9.3], p = 0.003, respectively). EDIC did not correlate to OS or PFS
Purpose/Objective: Stereotactic Ablative Radiotherapy (SABR) is a
standard-of-care treatment for patients with early lung cancer (ELC) who are unfit for surgery or who opt for non-surgical treatment (1). Single-fraction SABR (SFSABR) is non-inferior to fractionated SABR in terms of efficacy and adverse effects for ELC (2,3).We hypothesised that with modern technology and workflow efficiency, we could deliver SABR for ELC within a single day (One-Stop-SABR) as an approach which would be attractive to patients living in rural/regional areas and those who were elderly/frail. Material/Methods: Setting: Single-centre prospective trial at a major metropolitan cancer centre in Australia (ACTRN12624001431516).Participants: 10 patients with ELC planned for non-operative treatment after lung MDM review. A rapid workflow for a single fraction (30Gy) lung SABR including use of autocontouring, close team communication and usual peer review standards was developed. Patients had a nurse-led survivorship consultation while planning took place.Each step within the radiotherapy planning process, from arrival at CT simulation, until the patient leaves the treatment bunker was timed.Patient acceptability was measured with a short experience survey.One-Stop-SABR would be deemed successful if the dual primary endpoints of technical feasibility (70% treated within 8 consecutive working hours from starting CT-simulation to completing treatment) and patient acceptability (70% reporting high overall satisfaction with the service) were achieved.A secondary outcome included a staff survey to assess acceptability of wider implementation of One-Stop SABR. Results: 10 patients (6 female, 4 male) were recruited. Median age was 76.5 (range 62-84). ECOG performance status was 1 for five patients and 2 for the other five. Median driving time from home to the treatment centre was 3 hours.Both primary endpoints were achieved. Nine of ten (90%) patients completed SABR within eight hours and. Median total time was 6h 55m (range 6h 26m – 8h 4m). All patients reported being ‘very satisfied’ (n=9) or ‘satisfied’ (n=1) with the One-Stop service. The majority (9/10) reported that out-of-pocket costs were less with One-Stop SABR than if multiple attendances had been required.All 20 staff survey respondents reported that quality of planning/treatment was equivalent or better than with our routine workflow. Nineteen (95%) reported that the One-Stop workflow is a beneficial alternative for selected patients. Conclusion:
Conclusion: Lower lymphocyte count was an independent negative prognostic factor for OS in LS-SCLC patients, while EDIC did not impact OS or PFS. Further research is needed to standardize lymphopenia thresholds, optimize RT, and minimize immune cell depletion, particularly when immunotherapy is planned References: Jin J-Y, Hu C, Xiao Y, Zhang H, Paulus R, Ellsworth SG, et al. Higher radiation dose to the immune cells correlates with worse tumor control and overall survival in patients with stage III NSCLC: a secondary analysis of RTOG0617. Cancers (Basel) 2021;13:6193.
https://doi.org/10.3390/cancers13246193. Keywords: LS-SCLC, Lymphopenia, EDIC
Mini-Oral 3883
A prospective trial of same-day sim-plan-and-treat single fraction SABR for early lung cancer (One- Stop SABR; ACTRN12624001431516). Neil D Wallace 1 , Thomas Devereux 2 , Brigid Moran 2 , Mark Burns 2 , Adam Yeo 3 , Vanessa Panettieri 3 , Nick Hardcastle 3,4 , Katrina Woodford 2 , Jasleen Kaur 2 , Jo Barber 2 , Janelle Diery 2 , Lewis Lee 2 , Sulman Rahim 2 , Mary Duffy 5 , Bianca deDios 6 , Nikki Plumridge 1,4 , Shankar Siva 1,4 , Mark Shaw 1,4 , Michael MacManus 1,4 , Susan Harden 1,4 1 Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia. 2 Radiation Therapy, Peter MacCallum Cancer Centre, Melbourne, Australia. 3 Medical Physics, Peter MacCallum Cancer Centre, Melbourne, Australia. 4 Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia. 5 Nursing, Peter MacCallum
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