CT Imaging in Detecting Lymph Node Metastases in Patients With Non-Small Cell Lung Cancer

Volume 96  Number 2S  Supplement 2016 level group within 3 months after the completion of IMRT, and so on for the third level group. Results: Fifteen men and 3 women were included in the trial. The median age was 53 years (30-68). Only 1 patient in level III developed grade 3 acute esophagitis, dysphagia, and fatigue during treatment. 9 patients (50%) experienced grade 2 acute esophagitis and dysphagia, 6 patients (33%) experienced grade 2 fatigue, and 2 patients (11%) in level III experienced grade 2 pneumonitis. 4 patients (22%) experienced grade 4 neutropenia and 3 patients (17%) experienced grade 3 thrombopenia. Late toxicities remained under observation. With median follow up of 6.9 months (3-36.2), one-year overall survival, progressionfree survival, and local control were 100%, 58.3% and 99.4%, respectively. Conclusion: Dose escalation in limited-disease small cell lung cancer has been safely achieved up to 54Gy for GTV using the SIB-IMRT technique. Acute toxicities were well tolerated, whereas late toxicities and long-term outcomes deserved further observation. Author Disclosure: A. SHI: None. J. You: None. Y. Wu: None. H. Yu: None. R. Yu: None. G. Zhu: None.

3134 A Pilot Study of 18F-ALF-NOTA-PRGD2 PET/CT Imaging in Detecting Lymph Node Metastases in Patients With Non-Small Cell Lung Cancer Y. Zhou,1 N. Liu,1 Y. Dong,1 Y. Huang,1 H. Lu,1 J. Zheng,1 X. Teng,1 K. Cheng,1 X. Sun,2 X. Hu,1 W. Zhao,1 S. Wang,1 S. Zhu,1 and S. Yuan1; 1 Shandong Cancer Hospital & Institute, Jinan, China, 2Shandong Cancer Hospital and Institute, Jinan, China Purpose/Objective(s): Angiogenesis is an important step in tumor development and metastasis. Integrin avb3 plays a primary role in angiogenesis. 18F-ALF-NOTA-PRGD2 (18F-alfatide) has been developed for positron emission tomography (PET) imaging of integrin avb3. This is a prospective study to analyze the diagnostic performance of 18F-alfatide PET/computed tomography (CT) to detect lymph node metastases (LNMs) in patients with non-small cell lung cancer (NSCLC). This study is supported by NSFC81172133 and NSFC81372413. Materials/Methods: 12 patients with NSCLC were enrolled in this study. All the patients underwent 18F-alfatide PET/CT before surgery. The uptakes of all dissected LNs on 18F-alfatide PET were assessed visually and analyzed with maximum and mean standard uptake value of LNs (SUVmaxLN, SUVmeanLN) and SUV ratios of LNs to primary tumor, mediastinal blood pool, and muscle as SUVLN/PT, SUVLN/MBP, SUVLN/M. Results: LNMs were pathologically confirmed and eighteen of 189 LNs were malignant. 16 LNs were successfully visualized on 18F-alfatide PET/CT and the sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) was 88.89%, 99.42%, 98.41%, 94.12%, and 98.84%, respectively. The SUVmax LN, SUVmean LN, SUVLN/PT, SUVLN/MBP, SUVLN/M of malignant lesions were significantly higher than those of benign lesions (2.160.50 VS 0.980.28, 1.680.35 VS 0.850.25, 0.580.22 VS 0.260.12, 2.300.80 VS 0.870.30 and 4.801.40 VS 2.000.63, respectively, all P values<0.001). According to receiver operating characteristic (ROC) curve analysis, the most significant parameter was SUVmax LN (AUCZ0.968). ROC analysis suggested a SUVmax LNcut-off value of 1.45 to differentiate malignant lesions and benign lesions. The sensitivity, specificity, accuracy, PPV, and NPV was 94.44%, 95.91%, 95.77%, 70.83%, and 99.39%, respectively. Conclusion: Our results suggest that PET/CT with the new tracer 18Falfatide is effective in the diagnosis of metastatic lymph node in patients with NSCLC. Additional studies with a larger number of patients are needed to validate our findings. Author Disclosure: Y. Zhou: None. N. Liu: None. Y. Dong: None. Y. Huang: None. H. Lu: None. J. Zheng: None. X. Teng: None. K. Cheng: None. X. Sun: None. X. Hu: None. W. Zhao: None. S. Wang: None. S. Zhu: None. S. Yuan: None.

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3135 Hypofractionated Stereotactic Radiation Therapy for Advanced Non-Small Cell Lung Cancer: Report on Clinical Outcome and Toxicity W. Guo,1 X.S. Gao,1 M.W. Ma,1 L.J. Han,1 B. Zhao,1 Z.G. Zhou,2 X. Qi,1 X.Y. Li,1 D. Zhou,1 M. Cui,1 and Y. Bai1; 1Department of Radiation Oncology, Peking University First Hospital, Beijing, China, 2Department of Radiation Oncology, Fourth Hospital of Hebei Medical University, Hebei, Shijiazhuang, China Purpose/Objective(s): Currently, hypofractionated stereotactic radiation therapy for early stage non-small-cell lung cancer (NSCLC) has been achieved a significant curative effect. However, it is still being explored for advanced NSCLC. This retrospective study was to report on longterm follow-up results and tolerance for the treatment of advanced NSCLC. Materials/Methods: From 2009 to 2014, 27 patients (IIIA: 13, IIIB: 2, IV: 12) with advanced stage NSCLC treated with hypofractionated radiation therapy were analyzed. Four patients for postoperative radiation therapy, 6 patients received chemotherapy before radiation therapy. X knife treatment was given to 11 patients, PTV prescription dose is 35-55Gy/10 20f, g knife treatment was given to 16 patients, PTV prescription dose is 21-50Gy/610f. Overall survival (OS) rates were calculated from the date of initial RT and were estimated using the KaplaneMeier method. Subgroups analyses using the log-rank test. The Common Terminology Criteria for Adverse Events (CTCAE) version 3.0 was used as the standard for the evaluation of treatment toxicity. A P value of less than 0.05 was considered statistically significant. Results: Median follow-up was 24 months (range, 6-72 months). The median OS was 24 months, with 1- and 3-year OS rates of 73.7% and 36.4%, respectively. Prior chemotherapy vs. radiation therapy alone had no significantly better OS (PZ0.58). Female patients vs. male patients had a significantly better on OS (PZ0.01).The percentages of Grade II acute erythema and Grade II chest pain were 4% and 7%, respectively. Three patients (11%) had Grade I late esophagitis toxicity. The percentages of Grade I and Grade II late chest pain were 4% and 7% respectively. Acute or late Grade III and above toxicity did not occur. Conclusion: Hypofractionated radiation therapy is a feasible methods and well-tolerated treatment for patients with advanced NSCLC. The results still need large-scale clinical trials to verify. Author Disclosure: W. Guo: None. X. Gao: None. M. Ma: None. L. Han: None. B. Zhao: None. Z.G. Zhou: None. X. Qi: None. X. Li: None. D. Zhou: None. M. Cui: None. Y. Bai: None.

3136 Risk Factors of Radiation Pneumonitis After Stereotactic Ablative Body Radiation Therapy for Primary and Metastatic Lung Tumors K. Kim,1 C.G. Lee,2 and J.H. Cho3; 1Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea, 2Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University Health System, Seoul, Korea, The Republic of Korea, 3 Departments of Radiation Oncology, Yonsei University College of Medicine, Yonsei Cancer Center, Seoul, Korea, The Republic of Korea Purpose/Objective(s): Based on the excellent local control, stereotactic ablative body radiation therapy (SABR) is now widely used in early stage primary or metastatic lung nodules. However there’s no clear consensus on the risk factors of radiation pneumonitis following SABR. In this study we aimed to find out the radiation-dose volume metric risk factors affecting the incidence of radiation pneumonitis in the clinical setting of SABR. Materials/Methods: We retrospectively reviewed 72 lesions in 59 patients who were treated with SABR for primary lung cancer or metastatic lesion. Four dose schemes of BED10Gy over 100 Gy were used for SABR, 45 Gy in 3 fractions (fx), 48 Gy in 4 fx, 60 Gy in 3 fx, and 60 Gy in 4 fx. RP was graded according to the Common Terminology Criteria for Adverse Events (CTCAE) v4.03 and symptomatic RP was defined as grade 2 or worse.