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H.K. Ahn



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    P2.01 - Poster Session/ Treatment of Advanced Diseases – NSCLC (ID 207)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Treatment of Advanced Diseases - NSCLC
    • Presentations: 1
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      P2.01-009 - EGFR Mutation and Brain Metastasis in Patients with Non Small Cell Lung Cancer (ID 407)

      09:30 - 09:30  |  Author(s): H.K. Ahn

      • Abstract
      • Slides

      Background:
      It has been demonstrated that lung cancer is the most common cause of brain metastases(BM). This study was designed to analyse the association of timing and survival of BM according to histology and epidermal growth factor receptor (EGFR) mutation status in patients with metastatic nonsmall cell lung cancer (NSLCL).

      Methods:
      We retrospectively analysed the medical records of 268 patients with NSCLC in single center in Incheon, Korea who were tested for EGFR mutation analysis from January 2010 to August 2013. We analysed the cumulative incidence of BM regard to EGFR mutation status, the time from the diagnosis to the development of BM, the time from BM to death and median survival. Survival was estimated by the Kaplan-Meier method and compared with the log-rank test.

      Results:
      Out of 268 patients, 74 (28%) had BM, 54(73%) patients already at the time of diagnosis. Synchronous BM was more frequent in patient with EGFR mutation than WT EGFR patient (79% vs. 69%). But patients with metachronous BM, time to BM diagnosis was not significantly different according to EGFR status. (p=0.298) Among the 67 patients with BM, 25(37%) had mutations in EGFR, including 13 exon 19 deletions and 12 L858R mutations and 40 had WT (60%). The time from diagnosis of first brain metastases to death(BM-OS) was significantly longer in patient with EGFR mutation than WT (22.28 vs. 7.55 month, p<0.005). The BM-OS in EGFR mutated patients with synchronous BM was longer than in EGFR WT patients (25.42 vs. 8.86 month, p<0.005). But the BM-OS in EGFR mutated patients with metachronous BM was not significant different from WT EGFR patients. (p=0.16).

      Conclusion:
      NSCLC patients with EGFR mutations were more prevalent with synchronous BM than those with EGFR WT patients. EGFR mutation was associated with significantly longer survival from BM diagnosis, especially in those with synchronous BM.

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    P3.03 - Poster Session/ Treatment of Locoregional Disease – NSCLC (ID 214)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Treatment of Locoregional Disease – NSCLC
    • Presentations: 1
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      P3.03-020 - Outcomes of Concurrent Chemoradiotherapy in Elderly Patients with Stage III Non-Small Cell Lung Cancer (ID 2252)

      09:30 - 09:30  |  Author(s): H.K. Ahn

      • Abstract

      Background:
      The aim of this study was to assess the outcomes of concurrent chemoradiotherapy(CCRT) in elderly patients with stage III non-small cell lung cancer(NSCLC), focusing on the survival outcomes, prognostic factors and toxicities.

      Methods:
      From January 2006 to May 2012, 39 elderly patients older than 60 years (median 68 years; range 62~78 years) with stage III NSCLC were enrolled in this study. Radiotherapy (RT) was administered to the primary tumor and regional lymph nodes with concomitant administration of chemotherapy. The total RT dose was 46.8-79 Gy in daily 1.8-2.5 Gy fractions (median 66.6 Gy). Overall survival (OS) and progression free survival (PFS) were estimated with the Kaplan-Meyer method. Prognostic factors (gender, age, smoking, pathology, ECOG performance status, body weight, RT dose and tumor response) were analyzed by the log-rank test and Cox regression model. Acute toxicities were assessed according to Radiation therapy oncology group(RTOG) criteria.

      Results:
      The median follow-up period was 18.4 months. The 1, 2 and 3-year overall survival(OS) rates were 61.5%, 41.0% and 30.8%, respectively. The 1, 2 and 3-year progression free survival(PFS) rates were 51.7%, 30.0% and 21.8%, respectively. Multivariable analysis showed that ECOG performance status(p=0.002) and tumor response(p=0.001) significantly influenced OS. The tumor response(p=0.013) was a significant prognostic factor for PFS in multivariable analysis. The grade 3 or higher radiation pneumonitis and esophagitis were developed in 9 (23.1%) and 4 (10.3%) patients. Neutropenia with grade 3 or higher was developed in 8 patients (20.8%).

      Conclusion:
      Survival (OS and PFS) of elderly patients with stage III NSCLC treated with CCRT is significantly affected by tumor response. However, the survival outcomes for elderly patients with stage III NSCLC treated with CCRT showed comparable results with previous reports. The CCRT related toxicity such as pneumonitis and neutropenia were relatively higher. These results means that CCRT is effective in increasing survival, however, the careful selection of elderly NSCLC patients for CCRT is also required.