Author of

• 17783

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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)

  • 17804

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    P2.05-021 - Stereotactic Radiosurgery for Brain Metastasis in Non-Small Cell Lung Cancer: Predictor of Intracranial Progression (ID 6266)

    14:30 - 14:30  |  Author(s): Y.S. Kim
    • Abstract

    Background:
    Stereotactic radiosurgery (SRS) has been introduced for small-sized single and oligo-metastases in the brain. The aim of this study is to assess treatment outcome, efficacy, and prognostic variables associated with survival and intracranial recurrence.
    
    Methods:
    This study retrospectively reviewed 123 targets in 64 patients with non-small cell lung cancer (NSCLC) treated with SRS between January 2006 and December 2012. All patients underwent SRS with 2000~3000cGy/1~3Fx for each brain metastasis as a initial treatment or salvage treatment for recurrence after whole brain RT. Median target number and size were 2 targets and 1cm in diameter. Every patient was evaluated according to Eastern Cooperative Oncology Group (ECOG) performance status, RPA class, number and size of brain metastasis and other systemic metastasisdisease staus before SRS. We evaluated overall survival (OS), local tumor control and intracranial progression free survival rate (IPFS) of patients. We also evaluated quality of life immediate after SRS.Treatment responses were evaluated using magnetic resonance imaging.
    
    Results:
    The median follow-up was 13.9 months. The median OS and IPFS were 14.1 and 8.9 months, respectively. Fifty-seven patients died during the follow-up period. The 5-year local control rate was achieved in 85% of 108 evaluated targets. The 1- and 2-year OS rates were 55% and 28%, respectively. On univariate analysis, primary disease control (p < 0.001), the Eastern Cooperative Oncology Group (ECOG) performance status (0 or 1 vs. 2; p = 0.002), recursive partitioning analysis class (1 vs. 2; p = 0.001), and age (<65 vs. ≥65 years; p = 0.036) were significant predictive factors for OS. Primary disease control (p = 0.041) and ECOG status (p = 0.017) were the significant prognostic factors for IPFS. Four patients experienced radiation necrosis and no other neurocoginitive deficit by SRS was reported within follow up duration.
    
    Conclusion:
    SRS is a safe and effective local treatment for brain metastases in patients with NSCLC. Uncontrolled primary lung disease and ECOG status were significant predictors of OS and intracranial failure. SRS might be a tailored treatment option along with careful follow-up of the intracranial and primary lung disease status. Omission of WBRT can be option for patient with primary disease controlled and better ECOG with close image follow up.