Concurrent chemoradiotherapy (cCRT) at the Northern Centre for Cancer Care (NCCC): preliminary results from a stage III cCRT database

ABSTRACT

Introduction: Due to COVID-19, NCCC established a Stage III cCRT review clinic. From April 2020 a prospective audit of patients treated was established. Methods: All lung radiotherapy referrals were scrutinised from January-December 2020. Electronic data was obtained from radiotherapy software. Patients treated with cCRT were analysed for 1) Toxicity data. 2) Hospital admissions. 3) PDL1 status. 4) Adjuvant durvalumab treatment. Patients who received either unimodality radiotherapy or sequential chemoradiotherapy were reviewed for justification for not treating with cCRT . Results: Of 670 patients treated. 295 received palliative and 375 radical radiotherapy. 141 patients received radical radiotherapy (55Gy in 20#). 55 were Stage III NSCLC, 18 received sequential chemoradiotherapy. 49 patients received cCRT, 41 were stage III NSCLC. 55 stage III patients did not receive cCRT. 8 reason codes were identified 1) Comorbidity (N=16). 2) Size (N=18). 3) No histopathology (N=3). 4) Consented for cCRT, but disease progression/too big at time of radiotherapy planning (N=6). 5) Relapse (N=3). 6) Reason not annotated (N=5). 7) Patient declined (N=2). 8) Adjuvant RT after surgery (N=2). Of the 41 cCRT NSCLC patients. All patients experienced some toxicity. There were no grade 4 toxicity. 2 patients reported Grade 3 toxicity (nausea and fatigue);dyspnoea, cough, fatigue, oesophagitis and nausea being the most common. 4 out of 41 patients were admitted. Reasons were dehydration, chest infection, oesophagitis, hyponatraemia, neutropenia. 1 patient did not proceed to durvalumab, due to deterioration of performance status. 30 out of 41 patients were PDL1 +, of which 26 were consented for durvalumab. Reasons for no durvalumab were rheumatoid arthritis, inflammatory bowel disease, interstitial lung disease and deterioration after cCRT. Conclusion: cCRT is an effective delivery as an outpatient. However, ongoing audit is imperative to ensure optimal patient treatment. The data as highlights multidisciplinary input is essential, as most cCRT patients experience toxicity. Disclosure No significant relationships.