In other news: ESTRO 2018
medwireNews: This roundup of research presented at ESTRO 37 – the annual meeting of the European Society for Radiotherapy & Oncology, held in Barcelona, Spain – covers chemoradiotherapy in older non-small-cell lung cancer (NSCLC) patients, predictors of mortality in radiotherapy-treated NSCLC patients, and ultra-hypofractionated radiotherapy for prostate cancer.
Analysis of data from a phase II trial involving 300 patients with stage III NSCLC indicates that older patients (≥75 years) who receive concurrent chemoradiotherapy have worse overall survival (OS) than younger patients, but that OS is comparable across age groups receiving sequential chemoradiotherapy or radiotherapy alone.
“These findings underscore the need for prospective studies including geriatric assessment in this understudied patient population to identify predictive factors for treatment outcome, including quality of life and patient reported outcome measures,” said presenting author Judith van Loon (MAASTRO Clinic, Maastricht, the Netherlands).
The aim of the trial was to assess the feasibility of the isotoxic principle in patients receiving intensity-modulated radiotherapy.
In a study of 226 patients with unresectable stage I NSCLC undergoing stereotactic body radiotherapy, handgrip weakness was a significant predictor of mortality, reported Stéphanie Peeters, from the MAASTRO Clinic.
After adjusting for variables, the 31% of patients with baseline handgrip weakness – defined as maximal handgrip strength below the tenth percentile of UK Biobank reference values, taking into account gender, age, and height – had a significant 1.98- and 1.52-fold increased risk for death at 1 and 5 years, respectively, than their counterparts without weakness.
“Handgrip strength is an objective, cheap and easy to measure independent prognostic parameter for short- and long-term OS” in these patients, the authors conclude.
Anders Widmark, from Umeå University in Sweden, presented the efficacy outcomes from the phase III HYPO-RT-PC trial, showing that ultra-hypofractionated radiotherapy is noninferior to conventionally fractionated radiotherapy for men with intermediate- or high-risk prostate cancer.
At the 5-year mark, 83.7% of 589 patients randomly assigned to receive 42.7 Gy in seven fractions over 2.5 weeks were free of biochemical or clinical failure. This was similar to the 83.8% rate for the 591 participants given conventionally fractionated radiotherapy, that is, 78.0 Gy in 39 fractions over an 8-week period.
The incidence of genitourinary and gastrointestinal adverse events of grade 2 or worse was also comparable between groups at 4 and 6 years.
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