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A. Bruni
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P3.07 - Poster Session/ Small Cell Lung Cancer (ID 223)
- Event: WCLC 2015
- Type: Poster
- Track: Small Cell Lung Cancer
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P3.07-011 - Profilattic Cranial Irradiation (PCI) Following Toracic CHT-RT for Small Cell Lung Cancer: Retrospective Analysis of 182 Consecutive Patients (ID 1017)
09:30 - 09:30 | Author(s): A. Bruni
- Abstract
Background:
The role of PCI in the management of Small Cell Lung Cancer (SCLC) pts is still debated. Several studies showed its effectiveness in terms of progression (PFS) and metastasis free survival (MFS), but advantages for overall survival (OS) are not always reported. The aim of our analysis is to retrospectively evaluate the current clinical impact of PCI in patients affected by SCLC.
Methods:
From April 1989 to May 2014 a total of 182 pts with SCLC underwent radical concomitant or sequential CHT-RT on thoracic disease +/- PCI in two different Italian Institutions. Thirty-eight pts were female, while 144 were male. Mean and median age were respectively 62.6 (range 38-86) and 63 years. Only 5 pts had “extended disease”, while the other 177 had T1-T4 N0-N2 limited stage SCLC. Seven pts underwent surgery followed by adjuvant CHT-RT on mediastinal nodes while 8 pts didn’t received any RT for primary disease; the remaining 167 pts received concomitant/sequential CHT-RT with radical intent. After receiving CHT or CHT-RT for thoracic disease, 66/182 pts received PCI, while 118/182 pts underwent regular clinical/radiological follow up. Most of patients were routinary followed in out-patient clinic every three months and they were also submitted to neurocognitive questionnaires. All PCIs were planned using opposite lateral fields with 2D technique or virtual off-line simulation; all pts received 25-30 Gy in 10 fractions within two weeks. Three- and 5-year OS,PFS and Brain mts free survival (BrMFS) were analyzed; univariate and multivariate analysis (using Kaplan Meier and Cox Regression tests) were performed due to identify patient, tumor and/or treatment related prognostic factors
Results:
: We retrospectively analyzed our cohort of patients using Kaplan Meier curves for survival and Cox regression tests for univariate and multivariate analysis. At a mean follow up of 32 months, no difference in terms of OS, PFS and brMFS was found comparing population referring to the 2 different centers. In the analyzed population 3- and 5-year OS were respectively 28.2 and 18.4%, while PFS were 22.4 and 18.9 respectively. Finally 3- and 5-year BrMFS were 56.3 and 50.2%. By multivariate analysis PCI and clinical response to primary thoracic treatment remain as independent variables being protective in terms of OS, PFS and BrMFS. Concomitant CHT-RT and RT on thoracic disease are positive factors just for PFS (respectively with p<0.014 and p<0.025). No G3 or G4 acute/late toxicities were found.
Conclusion:
PCI after primary thoracic CHT-RT with radical intent was confirmed as a “treatment-key” in the management of SCLC having also an optimal toxicity profile. Our data confirmed that PCI will be encouraged in all fit patients due to its potential benefit in terms of OS, PFS and BrMFS. Pts with Limited Stage SCLC having experienced a good response to primary CHT-RT treatment on thoracic disease seems to be the optimal candidate to PCI.
