Author of

• 10692

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  P1.08 - Poster Session 1 - Radiotherapy (ID 195)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Radiation Oncology + Radiotherapy
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/28/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 10700

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    P1.08-008 - Prognostic factors in patients with brain metastasis from non-small cell lung cancer treated with whole-brain radiotherapy (ID 830)

    09:30 - 09:30  |  Author(s): Y. Nakasu
    • Abstract

    Background
    To evaluate the prognostic factors associated with overall survival in patients with brain metastasis from non-small cell lung cancer(NSCLC) who received whole-brain radiotherapy (WBRT).

    Methods
    From September 2002 to December 2010, 257 patients with brain metastasis from NSCLC who received WBRT. Those who had undergone craniotomy or stereotactic radiotherapy before WBRT and those with leptomeningeal metastasis were excluded. The prognostic factors evaluated for overall survival were; gender, neurological deficit, histology, epidermal growth factor receptor (EGFR) mutation status, previous cytotoxic chemotherapy, previous EGFR tyrosine kinase inhibitor (TKI) treatment, RTOG-recursive partitioning analysis (RPA) (age,Karnofsy Performance Scale [KPS], primary tumor control), and diagnosis-specific graded prognostic assessment (DS-GPA)(age, KPS, extra cranial control, number of lesions). All factors with a Pvalue < 0.05 at univariate analysis were entered into a multivariate analysis using Cox regression with confidential interval of 99%.

    Results
    At the time of analysis, 225 patients (88%) died, 14 patients (5%) were alive, and 18 patients (7%) were lost to follow-up. The median follow-up time was 16.2 months. The median survival time (MST) was 5.6 months and 1-year survival rate was 28.6%. The MST according to gender, neurological deficit, histology, EGFR mutation status, previous chemotherapy, previous EGFR-TKI treatment, RPA class, and DS-GPA were shown in Table 1. In univariate analysis, the significant prognostic factors were; gender (P=0.0002), neurological deficits (P<0.0001), histology (P<0.0001), previous chemotherapy (P=0.0463), EGFR mutation (P=0.0236), RPA class (P<0.0001) and DS-GPA (P=0.0003). In multivariate analysis, RPA class (I and II vs III,KPS>70 vs <70), histology (adenocarcinoma vs non-adenocarcinoma) and previous chemotherapy (none vs present) were found to be significant prognostic factors (Table 2).Figure 1 Figure 2

    Conclusion
    RPA class I or II (KPS>70), adenocarcinoma and no previous chemotherapy were associated with longer survival. These factors should be taken into account for decision-making in an attempt to find optimal treatment for patients with brain metastasis.