Poster Presentation 37th TROG Cancer Research Annual Scientific Meeting 2025

SABR One Stop Service for Early Lung Cancer: Same-Day Sim-Plan-and-Treat Single Fraction Stereotactic Ablative Radiotherapy (#102)

Neil Wallace 1 , Mark Burns 1 , Thomas Devereux 1 , Brigid Moran 1 , Nick Hardcastle 1 , Vanessa Panettieri 1 , Adam Yeo 1 , Jasleen Kaur 1 , Joanne Barber 1 , Janelle Diery 1 , Lewis Lee 1 , Bianca deDios 1 , Mary Duffy 1 , Michael MacManus 1 2 , Nikki Plumridge 1 2 , Mark Shaw 1 2 , Shankar Siva 1 2 , Susan Harden 1 2
  1. Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
  2. The Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia

Background

Stereotactic Ablative Radiotherapy (SABR) is treatment of choice for most medically inoperable patients with early-stage lung cancer (ELC) since the TROG 09.02 CHISEL trial. Randomized phase II trials have demonstrated non-inferiority for single-fraction SABR (SFSABR) vs fractionated SABR for ELC, as did the TROG 13.01 SAFRON II trial for pulmonary metastases. We hypothesised that with modern planning technology and coordinated multi-disciplinary teamwork, we could develop a quality assured one-day service for planning and delivering curative intent SFSABR and that this service might benefit people who are elderly, frail, or living in rural/remote areas.

 

Aims

To demonstrate the technical feasibility and patient acceptability of same day SFSABR for ELC.

 


Methods

Single centre prospective study.

Participants: 10 patients with ELC deemed treatable with SFSABR by the Lung MDM will be recruited and undergo CT simulation, planning and delivery of 30Gy/1fx SFSABR within 8 hours.

 

Design:

Technical rapid workflow feasibility will be determined by recorded timings along the whole simulation, planning, QA and treatment delivery process, chart round peer review and multidisciplinary team feedback.

Participant acceptability will be determined with nursing support by patient feedback through a short experience survey, completed within 2 weeks of SFSABR.

Study endpoints

-Technical: Proportion where time from commencement of planning CT to completion of treatment is <8 working hours.

-Patient acceptability: Participant feedback and proportion reporting high overall satisfaction.

 

Results

4/10 patients have been recruited from June-September 2024. The technical feasibility 8-hour target has been achieved for 4/4 treated. Participant overall satisfaction is ranked as very high for 4/4.

 

Conclusions

Early indications suggest people with ELC can safely have CT simulation, planning and SFSABR treatment within a single working day. This may be a particularly attractive option for those living in remote areas or when multiple hospital visits are a barrier to accessing curative treatment.