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C.R. Lewis
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P2.15 - SCLC/Neuroendocrine Tumors (ID 716)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: SCLC/Neuroendocrine Tumors
- Presentations: 1
- Moderators:
- Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P2.15-007 - Extensive Stage Small Cell Lung Cancer: Patterns of Care and Outcomes of a Single Institution over 15 Years (ID 8908)
09:30 - 09:30 | Author(s): C.R. Lewis
- Abstract
Background:
Survival outcomes for extensive stage small cell lung cancer (ES-SCLC) remain poor. The standard management of ES-SCLC is chemotherapy. For those achieving a good response consolidation thoracic radiotherapy and prophylactic cranial irradiation (PCI) is considered. This retrospective audit analysed patterns of care and survival for all patients with ES-SCLC treated at Prince of Wales Hospital (POWH) over 15 years. Factors correlating with survival were also analysed. A literature review was performed to benchmark our results.
Method:
We identified 187 patients diagnosed with SCLC at Prince of Wales Hospital between 2000 and 2014 from the departmental electronic patient information system (MOSAIQ, Elekta). Eligibility criteria were: age >18 years, histopathologically confirmed diagnosis of SCLC, extensive stage according to the two-stage Veterans’ Affairs Lung Study Group staging criteria, and treatment at POWH. Median progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan-Meier method and log-rank test (IBM SPSS version 24).
Result:
Eighty-three patients fulfilled the eligibility criteria. Median age was 70 years. 42% of patients were female and 63.9% had an Eastern Cooperative Oncology Group performance status (PS) of 0-1. Median PFS and OS were 5.0 and 8.2 months respectively, comparable with published literature. There was correlation between PS (0-1 versus >2) and OS (p=0.025) but not PFS (p=0.16). 79.5% of patients received initial chemotherapy, 48.5% of these patients received 6 cycles, of which 89.4% was carboplatin and etoposide. Median time from date of diagnosis to start of chemotherapy was 12 days, with correlation between time to chemotherapy and OS (p=0.006) and PFS (p=0.003). 75.9% patients received radiotherapy of any kind, but only radiotherapy directed at the thorax was associated with improved OS (p=0.01) but not PFS (p=0.5). Five (6%) patients underwent consolidation thoracic radiotherapy, while 32.5% underwent palliative thoracic radiotherapy. Palliative whole brain radiotherapy was given to 11 (13.3%) patients and only 2 patients received PCI. 78.3% of patients had documented progression after treatment, with simultaneous loco-regional and distant progression the most common pattern. 66.2% of patients had treatment at progression, with most (86%) receiving palliative radiotherapy.
Conclusion:
Our current analysis demonstrates an association between survival outcomes and baseline PS, time to initiation of chemotherapy and receipt of thoracic radiotherapy for patients with ES-SCLC. The survival outcomes are comparable to the reported literature. This highlights the importance of early referral and treatment commencement for improved outcomes in ES-SCLC.
