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T. Akimoto
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P3.14 - Radiotherapy (ID 730)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Radiotherapy
- Presentations: 1
- Moderators:
- Coordinates: 10/18/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P3.14-001 - Impact of PCI on Prognosis of LD-SCLC Through Pattern of Brain Metastases as a First Recurrence Site (ID 9648)
09:30 - 09:30 | Author(s): T. Akimoto
- Abstract
Background:
Brain metastases frequently occur in patients with small-cell lung cancer. Therefore, prophylactic cranial irradiation (PCI) is recommended for good responders of initial treatment. The purpose of this study was to investigate influence of PCI on pattern of brain metastases as a first recurrence site (BMFR) after radical treatment for limited disease small-cell lung cancer (LD-SCLC).
Method:
This retrospective study included LD-SCLC patients treated with thoracic radiotherapy and concurrent chemotherapy between January 2006 and December 2014. Induction chemotherapy was permitted. Thoracic radiotherapy was performed with accelerated hyper-fractionated radiotherapy (twice daily, 45 Gy in 30 fractions over 3 weeks) or conventional-fractionated radiotherapy (once daily, 50 Gy in 25 fractions over 5 weeks). Regimen of chemotherapy consisted of intravenous platinum-etoposide.
Result:
One hundred and sixty-two patients were included in this study. The median follow-up duration for surviving patients was 38 months (range, 6-105 months). Among 123 patients (76%) who died, 104 patients died due to disease progression, 11 died due to unknown cause and 8 died due to other cause. Ninety-three patients (57%) underwent PCI, and the 3-year disease specific survival (DSS) rates were 20%(12-35) in patients without PCI and 43%(33-55) in those with PCI (p<0.001). Concerning the recurrence pattern, the frequency of BMFR was significantly higher in patients who did not underwent PCI compared with those who did (49% vs 25%, p=0.008) although no significant difference in frequency of all site of recurrence was observed between patients without PCI and those with PCI (83% vs 73%, p=0.109). Regarding the impact of BMFR on prognosis, patients with BMFR exhibited significant shorter DSS than those whose first recurrence sites was other than brain metastases (3yr-DSS 6% vs 22%, p=0.007), and patients who developed BMFR without PCI exhibited significant lower DSS compared with those who developed BMFR with PCI (3yr-DSS 0% vs 17%, p=0.005). In addition, 68% of patients who did not underwent PCI exhibited multiple BMFR lesions with 5 or more while 12% of patients who did (p<0.001).
Conclusion:
The results of this study indicated that BMFR exhibited significant negative impact on prognosis after radical treatment for LD-SCLC and the difference in the number of metastatic lesions in BMFR between patients with PCI and those without PCI might affect clinical outcomes.
