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)

  • 17547

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    P2.02-054 - Impact of Prognostic Nutrition Index for Induction Chemoradiotherapy Followed by Surgery in Locally Advanced Non-Small Lung Cancers (ID 4607)

    14:30 - 14:30  |  Author(s): T. Kurosaki
    • Abstract

    Background:
    The preoperative nutritional and immunological statuses have an important impact in predicting the clinical outcome of surgery. Induction chemoradiotherapy (iCRT) followed by surgery is one of treatment options for locally advanced (LA) non-small cell lung cancers (NSCLCs) although there is a risk for increasing postoperative complications with protracted would healing. A prognostic nutritional index (PNI), calculated using serum albumin levels and peripheral lymphocyte count, has been used to predict the clinical outcome of various cancers including early stage NSLCCs but not LA-NSCLC after iCRT. In this study, we investigated the impact of PNI on clinical outcome of iCRT followed by surgery in the patients with LA-NSCLCs.
    
    Methods:
    During 2009 to 2014, 70 patients underwent iCRT followed by surgery in Okayama University Hospital. We retrospectively calculated the PNI at (1) pre-iCRT, (2) pre-operation (Ope), and (3) post-Ope (about one month later) and reviewed the medical records.
    
    Results:
    The median age was 63 years old (range 34 – 78) and 53 patients were male. Forty-three patients were adenocarcinomas and 24 were squamous cell carcinomas. Clinical stages were IIA (n =3), IIB (n = 6), IIIA (n = 44), IIIB (n = 15), and IV (n = 2). Main regimen of iCRT was CDDP / DOC with concurrent radiotherapy (46 gray). Treatment responses were partial response (n = 44), no change (n = 24), and progressive disease (n = 2). Lung resections were lobectomy (n = 66), bi-lobectomy (n = 6), and pneumonectomy (n = 2) and additional procedure such as combined resection was performed in 43 patients (61%). Pathological responses were Ef1 (n = 20), Ef2 (n = 29), and Ef3 (n = 21). The median values of PNI were significantly decreased during treatment course [50 (39 – 71) in pre-ICRT, 45 (31 – 58) in pre-Ope, and 41 (24 – 54)]. We defined the cutoff value of PNI as 45 based on previous reports. The patients with high PNI (more than 45) in pre-iCRT showed significantly better prognosis than those with low PNI (3 years overall survival rate, 85% in high PNI vs 53% in low PNI, P = 0.03).
    
    Conclusion:
    Pre-treatment nutritional and immunological statuses that were evaluated using PNI may affect clinical outcome of the patients who received the iCRT followed by surgery for LA-NSCLCs.