Author of

• 17493

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  P2.02 - Poster Session with Presenters Present (ID 462)

  • Event: WCLC 2016
  • Type: Poster Presenters Present
  • Track: Locally Advanced NSCLC
  • Presentations: 1
  • Moderators:
  • Coordinates: 12/06/2016, 14:30 - 15:45, Hall B (Poster Area)

  • 17514

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    P2.02-021 - Extracranial Progression (ePD) after Chemoradiotherapy (CRT) for Stage III NSCLC: Does the Chemotherapy Regimen Matter? (ID 4887)

    14:30 - 14:30  |  Author(s): M. Van Den Heuvel
    • Abstract

    Background:
    In stage III NSCLC concurrent chemoradiation (cCRT) compares favourably to sequential CRT (sCRT). No superior chemotherapy regimen has been identified regarding (extracranial)PD. Previously we reported that the specific chemotherapy did not influence symptomatic brain metastases incidence. Here we analyse whether the specific chemotherapy influences occurrence of extracranialPD as first PD site (ePD~first~) after CRT.
    
    Methods:
    This retrospective multicenter study included all consecutive stage III NSCLC patients that completed CRT between 01-2006 and 06-2014. Primary endpoint was ePD~first ~(with/without cranial PD). Differences between regimens were assessed using logistic regression modelling including known relapse risk factors (age, gender, stage, histology) and the specific chemotherapy: cCRT versus sCRT. Within cCRT: daily low dose cisplatin (LDC) versus cyclic dose polychemotherapy (CDC); LDC versus (non-)taxane CDC; LDC versus subgroups of ≥50 CDC patients).
    
    Results:
    838 patients (737 cCRT, 101 sCRT) from 5 institutions were eligible. Median follow-up [95% CI] was 45.1 [42.3-47.8] months. 530 (63.2%) had PD, of which 463 (87.4%) had ePD~first. ~Median time to ePD~first~ was 16.6 [14.5-18.7] months. Patients with ePD~first~ had more often squamous histology (p=0.04). ePD~first~% or median time to ePD~first~ was not different for sCRT versus cCRT (table 1). 461 (62.6%) patients had PD after cCRT, of whom 401 (87.0%) had ePD~first~. ePD~first~% or median time to ePD~first~ did not differ between LDC and CDC. The chemotherapy regimen (cCRT versus sCRT) did not influence ePD~first~ on multivariate analysis: OR 0.81 [0.52-1.24] (p=0.33). LDC versus CDC cCRT did not differ: OR 0.96 [0.72-1.29] (p=0.80). Comparable results were found for LDC versus CDC non-taxane (N=277) and CDC taxane regimens (N=69) and for cCRT regimens with ≥50 patients (LDC versus cisplatin/etoposide (N=188), cisplatin/vinorelbin (N=65), weekly cisplatin/docetaxel (N=60)).

    Table1

    	concurrent N=737	sequential N=101	p-value
    PD N(%)	461 (62.6)	68 (68.3)	0.18
    ePDfirst N(%) -patients with concomitant brain metastases	401 (87.0) -38 (9.5)	62 (89.9) -8 (12.9)	0.19
    median time to ePD [95%CI] months	17.5 [15.0-20.0]	14.3 [11.9-16.7]	0.16
    	LDC N=391	cyclic dose N=346	p-value
    PD N(%)	245 (62.7)	216 (62.4)	0.33
    ePDfirst N(%) -patients with concomitant brain metastases	211 (86.1) -17 (8.1)	190 (88.0) -21 (11.1)	0.80
    median time to ePD [95%CI] months	17.4 [14.3-20.5]	18.3 [14.2-22.5]	0.59

    
    
    Conclusion:
    Sixty-three percent of stage III NSCLC patients developed PD, of whom 87% had ePD~first~. Incidence of ePD~first~ is independent of the specific chemotherapy regimen.