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E.K. Kirakli
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MA11 - Novel Approaches in SCLC and Neuroendocrine Tumors (ID 391)
- Event: WCLC 2016
- Type: Mini Oral Session
- Track: SCLC/Neuroendocrine Tumors
- Presentations: 1
- Moderators:P. Lara, A. Mohn-Staudner
- Coordinates: 12/06/2016, 14:20 - 15:50, Strauss 3
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MA11.11 - Is Hippocampal Avoidance during Whole Brain Radiotherapy Risky for Small Cell Lung Cancer Patients? (ID 3735)
15:32 - 15:38 | Author(s): E.K. Kirakli
- Abstract
- Presentation
Background:
Hippocampal avoidance (HA) during whole brain radiotherapy (WBRT) is performed to prevent neural stem-cell injury causing decreased neurocognitive function. Nevertheless, the estimated risk for metastases in HA area in small cell lung cancer (SCLC) patients is unknown. The current study aimed to characterize the metastatic distribution within the brain relative to the hippocampus and estimate the incidence of hippocampal metastasis in SCLC patients and also identify clinical and radiographic variables that may be associated with the presence of metastases within the HA area.
Methods:
SCLC patients treated with WBRT between January 2010 and December 2015 were reviewed. T1-wighted, post-contrast axial MRI (1.5 or 3 Tesla) images obtained just before therapeutic cranial irradiation were retrieved and reviewed for each patient. The HA area was generated by expanding the hippocampal contour by 5 mm volumetrically to account for necessary dose fall-off between the hippocampus (HP) and the whole brain planning target volume. Metastatic lesions within HP or HA area were defined as HP metastasis. HP metastasis rate was evaluated and characteristics of patients with HP metastasis were analyzed and compared to patients without HP metastasis.
Results:
54 patients evaluated with cranial MRI were enrolled. HP metastasis rate was 32% (17 patients). 4.4% of all metastases involved the HP and HA area (2.2% of metastases each) Figure 1. The most common location of metastasis was frontal lobe followed by cerebellum and temporal lobe. Having diabetes mellitus (OR: 12.1, 95% CI: 1.1-137.4, p=0.045) and being younger than 65 years of age (OR: 4.8, 95% CI: 1-23.2, p=0.049) were found to be independent risk factors for HP metastasis.
Conclusion:
HP metastasis might be more common in SCLC patients. Reducing the dose to the HP by HA-WBRT plan in SCLC may be risky for the development of HP metastasis compared with other malignant solid tumors.
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P1.08 - Poster Session with Presenters Present (ID 460)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Surgery
- Presentations: 1
- Moderators:
- Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)
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P1.08-070 - Salvage Lung Surgery: Difficulties and Results (ID 5447)
14:30 - 14:30 | Author(s): E.K. Kirakli
- Abstract
Background:
Thoracic surgeons often encounter lung resections following neoadjuvan treatments. Despite that, sometimes patients have curative chemo or/and radiotherapy treatments according to being inoperable for different reasons at the time of diagnosis. After these treatments due to residual tumour or relapses, surgery might be performed and this kind of surgery is called “salvage surgery”. This surgery has more difficulties and complications because of the adverse effects of definitive therapies. In this study we retrospectively analysed such patients undergone salvage surgery, and looked for an answer if we have to avoid or not?
Methods:
Patients operated after curative chemo or/and radiotherapy (4 cycles and more chemotherapy and 66 Gy radiotherapy is accepted as curative radiotherapy) between January 2010 and December 2014 were included in this study and analysed retrospectively. Demographic data, surgical management, morbidity, mortality and survival results were collected.
Results:
Having the described criteria 69 cases (62 male, 7 female) were included in the study. Six of the cases had chemotherapy, 8 radiotherapy only and remaining 55 had only chemotherapy (4-12 cycles). At the postoperative period, 5 cases were undergone rethoracotomy, 10 had prelonged air leakage and were externed with “Heimlich Valve” system, 5 had intraoperative vascular injury; 1 chylothorax, 4 secretion retantion requiring bronchoscopy, and 2 (2.3%) mortality occured. The mean follow up time was 27.6±20.5, ranging with 0.1-69.7 months. Five year survival was calculated as 51.9%.
Conclusion:
Complications after resective surgery following curative treatments are at acceptable rates. Besides this, the 51.9% five year survival rate seems like a last chance for such patients who have had their definitive treatment.
