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B. Vellayappan
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P2.07 - Poster Session/ Small Cell Lung Cancer (ID 222)
- Event: WCLC 2015
- Type: Poster
- Track: Small Cell Lung Cancer
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.07-007 - Prophylactic Cranial Irradiation for Extensive Stage Small Cell Lung Cancer (ID 52)
09:30 - 09:30 | Author(s): B. Vellayappan
- Abstract
Background:
The survival benefit of prophylactic cranial irradiation (PCI) in extensive stage small-cell lung cancer (ES-SCLC) reported by an EORTC randomized trial in 2007 has been questioned recently, as a Japanese study with similar trial design failed to show similar results. This retrospective cohort study aims to evaluate the uptake of PCI and its impact on the survival of ES-SCLC before and after publication of the EORTC randomized trial.
Methods:
All patients diagnosed with ES-SCLC without brain metastases and had stable disease or better after first line chemotherapy in the only two Singapore national cancer centers from 2003 to 2010 were identified using the institutions’ pathology registries. We linked the treatment records to the national death registry. We described the utilization of PCI and compared survival of patients diagnosed from 2003 to 2006 (pre-adoption cohort) with patients diagnosed from 2007 to 2010 (post-adoption cohort). Characteristics between pre and post-adoption cohorts were analyzed using chi-square test. Survival was determined from date of diagnosis to death using Kaplan-Meier method. Predictors for improved survival were determined using multivariate analysis.
Results:
71 patients were identified. The demographic and clinical characteristics were similar between the two cohorts save for more patients in the post-adoption cohort having second line therapy (49% versus (vs) 16%, P = 0.01) and receiving PCI (32% vs 10%, P = 0.04). There was no difference in overall survival between the two cohorts (Hazard ratio [HR] 0.70; 95% Confidence Interval [CI] 0.43 to 1.13, P = 0.148). Multivariate analysis showed that PCI (HR 0.47; 95% CI 0.24 to 0.91, P = 0.024) and thoracic radiotherapy (HR 0.49; 95% CI 0.28 to 0.86, P = 0.013) was associated with lower risk of death.
Conclusion:
There was an increase in the uptake of PCI for ES-SCLC since 2007. The use of PCI and thoracic radiotherapy has been shown to be predictors for improved survival in ES-SCLC who had stable disease or better after first line chemotherapy. A larger population based outcome study is warranted to confirm these observations.
