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S. Tendler
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P1.07 - Poster Session with Presenters Present (ID 459)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: SCLC/Neuroendocrine Tumors
- Presentations: 1
- Moderators:
- Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)
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P1.07-044 - Educational Level and Management in Small-Cell Lung Cancer (SCLC): A Population-Based Study (ID 4568)
14:30 - 14:30 | Author(s): S. Tendler
- Abstract
Background:
In a previous study we reported that educational level is a prognostic factor in SCLC, with females and LD patients with a higher education having a longer survival. In this study we examined possible associations between educational level, lead times and treatment strategies in the same cohort.
Methods:
The study was based on information in LcBaSe, a lung cancer research database generated by record linkages between the Swedish National Lung Cancer Register and several other population-based registers. Educational level was categorized according to number of years of schooling;low(≤ 9 years), middle (10-12 years), high (≥13 years). Stage was classified as limited disease (LD) and extensive disease (ED). Lead times were defined as A) from first radiological sign of a tumor to definite diagnosis and B) from date of referral from primary care to diagnosis. Treatment groups were divided as; chemotherapy (CT), CT+Radiation Therapy (CT+RT), Palliative RT or no oncological therapy.
Results:
The study population encompassed 4278 patients with a SCLC diagnosis between 2002-2011. Median age was 69 years. 988 (23.1 %) patients were diagnosed with LD (low E: 22.9 %, middle E: 23.6%, high E: 26.7 %) and 3187 (74.5 %) with ED (low E: 74.8, middle E: 74.0 %, high E: 73.3%) .One fifth of patients had a poor performance score (PS 3-4). The median lead time A was 14 days (IQR 5-32 days) and for lead time B 9 days (IQR 3-21 days). There were no differences in lead times between the educational groups. The proportion of patients receiving CT+RT was approximately 80 % in LD (Low E: 78.5% Middle E: 79.2% High E: 82.4 %) and 5 % in ED (Low E: 4.2%, Middle E: 5.3% High E: 6.8%). The percentage of patients receiving CT was 18 % in LD (Low E: 19.7% Middle E: 18.7 % High E: 15.3%) and 82 % in ED (Low E: 81.2 %, Middle E: 83.9 % High E: 81.4 %).
Conclusion:
There were no significant differences between educational groups in lead times or management. We conclude that the prognostic impact of educational status in Swedish SCLC patients does not appear to reflect inequalities in access to the healthcare.
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P2.05 - Poster Session with Presenters Present (ID 463)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Radiotherapy
- Presentations: 1
- Moderators:
- Coordinates: 12/06/2016, 14:30 - 15:45, Hall B (Poster Area)
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P2.05-033 - Predictors of Survival after Whole Brain Radiotherapy for Patients with Brain Metastasized Lung Cancer (ID 4794)
14:30 - 14:30 | Author(s): S. Tendler
- Abstract
Background:
Whole Brain Radiotherapy (WBRT) has been the standard of care for multiple brain metastases, but due to its toxicity and lack of survival benefit, its use in the palliative setting has started to be questioned. New clinical algorithms regarding the correct use of WBRT are needed.
Methods:
This was a retrospective, single institution cohort study, consisting of 280 patients with brain metastasized lung cancer who received WBRT at Karolinska University Hospital between 2010 and 2015. Information about RPA and GPA scores, demographics, histopathological results and received oncological therapy was collected. Predictors of Overall survival (OS) from the time of received WBRT were identified by Cox regression analyses. OS between GPA and RPA classes was compared by pairwise log rank test. A subgroup analysis was performed stratified by RPA class. Separate multivariate analyses were performed for RPA and GPA scoring systems, due to significant collinearity between them.
Results:
Median OS was 324, 130 and 41 days for RPA class 1(n=13), 2(n=165) and 3(n=101), respectively. Median OS for GPA groups 0 (0-1 points, n=168), 1 (1.5-2.5 points, n=98) and 2 (3-4 points, n=13) was 55, 166 and 110 days, respectively. Age>70 years was associated with worse OS. OS differed significantly between RPA class 1 versus 3 and 2 versus 3, GPA groups 0 versus 1 and age (p<0.0001 for all comparisons). Multivariate analyses are shown in table 1.Figure 1
Conclusion:
WBRT should be omitted for RPA class 3 patients. RPA class 1 patients should receive WBRT if clinically indicated. For RPA class 2 subgroup, patients with age≤70 years and GPA≥1.5 points should be treated as RPA 1, whereas patients with age>70 and GPA<1.5 points as RPA 3. WBRT is not recommended in patients older than 70 years and GPA≥1.5 points, and should be considered in younger patients with GPA<1.5 points.
