Background: The systemic immune-inflammation index (SII) correlates with patient survival in various types of solid malignancies, including non-small cell lung cancer (NSCLC). However, limited information is available on the prognostic implication and disease-specific survival of SII in patients undergoing definitive chemoradiation therapy (CRT) for stage III NSCLC.Methods: We retrospectively reviewed 125 patients who underwent curative intent CRT for stage III NSCLC with sufficient laboratory assessment from 2010-2019. SII was calculated at the time of diagnosis as platelet count × neutrophil count/lymphocyte count. Chi-squared analysis was used to compare categorical variables. A Kaplan-Meier analysis was performed to estimate progression-free survival (PFS), disease specific survival (DSS), and overall survival (OS) rates, with Cox regression used to determine absolute hazards.Results: At a median follow-up of 19.7 months, 5-year OS, DSS, and PFS rates were 22.6%, 30.9%, and 13.4%, respectively. A low SII (<1,266) at diagnosis was independently associated with an improved OS (HR:

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Purpose: The systemic immune-inflammation index (SII) is correlated with patient survival in various solid malignancies including non-small cell lung cancer (NSCLC). However, limited information is available on the prognostic implication of SII in patients undergoing trimodality therapy for stage III Non-Small Cell Lung Carcinoma (NSCLC). Methods: At our institution, 81 patients underwent curative intent trimodality therapy (neoadjuvant chemoradiotherapy followed by surgical resection) for stage III NSCLC from 2004-2019. SII was calculated at the time of diagnosis as platelet count × neutrophil count/lymphocyte count. Chi-squared analysis was used to compare categorical variables. A Kaplan-Meier analysis was performed to estimate disease free survival (DFS), overall survival (OS), and freedom from recurrence (FFR) rates, with Cox regression used to determine absolute hazards. Results: Patients underwent neoadjuvant radiation therapy to a median dose of 4500 cGy concurrent with a median of 3 cycles of chemotherapy (most commonly carboplatin and paclitaxel) followed by surgical resection (86.4% lobectomy and 13.6% pneumonectomy) with mediastinal lymph node dissection. At a median follow-up of 68.4 months, a low SII (<1260) at diagnosis was independently associated with an improved OS (HR: 0.448, p=0.004), DFS (HR: 0.366, p<0.001), and FFR (HR: 0.325, p=0.002). Conclusions: We identified that a low SII was associated with improved OS, DFS, and FFR in patients undergoing trimodality therapy for stage III NSCLC. The interplay of the immune system and lung cancer outcomes remains an active area of investigation for which further study is warranted.

among survivors has been acceptable with no severe (>grade 3) side effects noted. Conclusion: We have been able to successfully deliver a total dose of up to 1800 cGy to the entire bony skeleton with our TMI technique without observing any dose-limiting toxicity among the patients. Further dose-escalation appears feasible, and treatment response is encouraging since the median time to relapse post second ASCT in this high-risk population appears to be consistent with that reported in the literature. We are now in the process of increasing the total dose to 2000 cGy/10fr/bid/5 days.

Purpose/Objective(s): Reduced radiation volumes in the combined modality treatment of early stage diffuse large B-cell lymphoma (ES-DLBCL) have been recommended by the International Lymphoma Radiation Oncology Group to limit the toxicity of treatment. Here, we present the outcome following Involved Node Radiation Therapy (INRT) in a singleinstitution cohort of ES-DLBCL patients. Materials/Methods: All clinical stage I-II ES-DLBCL patients diagnosed from 2010 to 2014 were included. Patients were staged with PET-CT scans, treated with R-CHOP (or CHOP-like) chemotherapy, and e if referred to radiotherapy e received 30 Gy to initial disease, or 40 Gy whenever PET+ lymph node remnants or initial bulky disease, in 2 Gy fractions according to INRT guidelines. After therapy, patients were followed for 5 years. Overall survival (OS) and progression free survival (PFS, defined as date of diagnosis to progression or death from any cause) were calculated using the Kaplan-Meier method. Results: A total of 120 patients were diagnosed with ES-DLBCL, of whom 108 patients were candidates for curative treatment and 68 patients were referred to INRT. Patient characteristics of the 68 irradiated patients are presented in Table 1. The median follow-up was 68 months (range: 5-100 months), three patients were lost to follow-up, and two patients relapsed 4 and 58 months post-treatment (crude relapse rate: 2.9%), respectively, both in previously uninvolved sites. A total of seven patients died, one from relapsed disease in the CNS and six from other causes. The 5-year OS and PFS were 91.9% (95%CI, 98.5-85.0) and 89.8% (95% CI, 82.0-97.6), respectively. Conclusion: Modern combined modality treatment using the involved node radiation therapy-concept offers excellent tumor control and survival in early stage diffuse large B-cell lymphoma.