Author of

• 11929

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  P2.22 - Poster Session 2 - Epidemiology, Etiology (ID 167)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Prevention & Epidemiology
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/29/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 11935

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    P2.22-006 - Retrospective analysis of non small cell lung cancer patients submitted to ressection or radiosurgery for brain metastasis (BM) at Brazilian National Cancer Institute (ID 1606)

    09:30 - 09:30  |  Author(s): A.H.I. Garcês
    • Abstract

    Background
    Lung cancer is the leading cause of death from cancer in the world and 70 to 85% of these tumors are non-small cell (NSCLC) type. Up to 50% of patients have metastatic disease at the diagnosis, and the brain is one of the most common sites of metastasis. Prognosis of patients with central nervous system (CNS) involvement is usually dismal and is determined by performance status (PS), systemic disease status and age. Recently there is a growing amount of evidence suggesting that aggressive treatment for patients with brain oligometastasis may improve prognosis.

    Methods
    In this retrospective cohort, forty-nine charts of patients with non-small cell lung cancer (NSCLC) metastatic to the brain and treated with neurosurgery (NS) or radiosurgery, between 1996 and 2008, were reviewed at the Brazilian National Cancer Institute. The primary outcome was overall survival (OS), defined as the interval from the diagnosis to death or last follow-up.

    Results
    Median age was 54 years (range 32-82), 61% were male and more than 95% had PS 0-1. Most patients were smokers (95.7%) and had adenocarcinoma (77.6%). Twenty-three patients (47.9%) presented with metastatic disease at diagnosis, and 13 (38.8%) with BM upfront. Imaging for the diagnosis of BM varied between computed tomography (CT) (n=19;38.8%), magnetic resonance (MRI) (n=12;24.5%), both CT and MRI (N=15;30.6%) and positron emission tomography (n=1;2%). Forty-three patients (87.8%) were submitted to NS and only one was treated with radiosurgery. Patients had more often single metastasis (84.8%), and none had more than three lesions. Most patients (80%) still received adjuvant whole brain radiotherapy (WBT) after NS. The median OS was 15.8 months (95% CI 9.4-22.2).

    Conclusion
    Our data confirmed that compared to historical control patients with good PS and brain oligometastasis could derive a better survival when submitted to aggressive local therapy. In our center, until 2008 NS was the most common procedure used and adjuvant WBT was still frequently indicated.