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A.M. Al Farsi
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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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P1.07-050 - Patterns of Relapse in Small Cell Lung Cancer (SCLC): A Retrospective Analysis of Outcomes from a Single Canadian Center (ID 5387)
14:30 - 14:30 | Author(s): A.M. Al Farsi
- Abstract
Background:
We conducted a retrospective review of small cell lung cancer patients (SCLC) to explore patterns of relapse and utility of Prophylactic Cranial Irradiation (PCI).
Methods:
A retrospective chart review was carried on patients diagnosed with SCLC from January 1[st] 2011 until December 31[st] 2014 and treated at Juravinski Cancer Center. The primary outcome was to determine pattern of first relapse. Secondary outcomes were physician assessed response rate, overall survival (OS), utilization of PCI, time to systemic relapse (TTR) and time to central nervous system (CNS) relapse.
Results:
A total of 275 patients were identified, of whom 46 (16.7%) received no chemotherapy (median OS 2.2 months (m)) and were not included in further analyses. The median age of 229 treated patients was 66 (SD 9.3) yrs. There were 115 men, 114 women, 84 (37%) had limited stage (LS) and 145 (63%) extensive stage (ES) disease, performance status (PS) was 0-1 in 133 (58%), PS2 in 66 (28%) and PS3-4 in 32 (13%). Brain metastases were present in 36 (16%) patients at diagnosis. Almost all patients received cisplatin (53%) or carboplatin (43%) plus etoposide chemotherapy. Most patients received 4 (23%), or more (52%) cycles of chemotherapy. Physician assessed RR was 68% (PR 61%, CR 7%) and 16% of patients progressed during first-line therapy. Thoracic radiation (TRT) was given to 112 (49%) of patients (LS 87%, ES 27%). Patients with brain metastases at diagnosis, or progressing during first-line chemotherapy were not considered eligible for PCI. Among 156 eligible patients, 80 (51%) received PCI (LS 64%, ES 39%). Forty-one patients (26.3%) declined PCI. The median overall survival for all patients was 11.1m (LS 21.7m, ES 8.9m). Relapse occurred in 167 (73%) of patients: CNS alone 8.7%, CNS plus systemic relapse (13.1%), thoracic (28%), extra-thoracic (9%), thoracic/extra-thoracic (14%). Median time to any relapse was 9.2m (LS 14.3m, ES 7.5m), while median time to CNS relapse was 6.9m (PCI given 6.2m, PCI not given 4.4m). Among 50 patients with CNS relapse, 16 received PCI (LS 9, ES 7) and 34 did not (LS 8, ES 26). Among 64 patients with thoracic relapse, 31 received TRT (LS 19, ES 12) and 33 did not (LS 5, ES 28).
Conclusion:
Only 50% of eligible SCLC patients receive PCI. CNS relapse occurs frequently and more commonly in patients who do not receive PCI. Implementation of PCI in routine clinical practice appears to influence patterns of recurrence.
