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D. De Ruysscher
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Combined treatment stage III (ID 3)
- Event: ELCC 2018
- Type: Educational session
- Track:
- Presentations: 1
- Moderators:S. Peters, M. Guckenberger
- Coordinates: 4/11/2018, 14:30 - 16:00, Room A
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Are current NTCP models useful for predicting radiation-induced toxicity? (ID 8)
14:30 - 16:00 | Presenting Author(s): D. De Ruysscher
- Abstract
- Presentation
Abstract not provided
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ESMO-IASLC Best Abstracts (ID 61)
- Event: ELCC 2018
- Type: Best Abstract session
- Track:
- Presentations: 1
- Moderators:M. Perol, L. Paz-Ares
- Coordinates: 4/13/2018, 16:45 - 18:30, Room B
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109O - Health-related quality of life (QoL) after prophylactic cranial irradiation (PCI) vs no PCI for stage III NSCLC patients: Results from the NVALT-11/DLCRG-02 study (ID 273)
16:45 - 18:30 | Author(s): D. De Ruysscher
- Abstract
- Presentation
Background:
The NVALT-11/DLCRG-02 randomized phase III study compared PCI to observation after chemo-radiotherapy for stage III NSCLC and showed a significant decrease in time to develop symptomatic brain metastases in the PCI arm at the expense of more low-grade mostly neurological toxicity (HR 0.25 95% CI 0.11–0.58). We here report on the QoL.
Methods:
EORTC QLQ-C30 and EuroQol 5D (EQ-5D) data measured before PCI and 3, 12, and 24 months thereafter were compared for both arms. Specifically, functional scales and global health status scores (QLQ-C30) as well as VAS and utility scores (EQ-5D) were analysed using non-parametric tests.
Results:
In total, 86 and 88 patients were included in the PCI and observational arm respectively, accumulating to 853 observations (five observations completely missing). Baseline QoL was similar between both arms, except for emotional (p = 0.025) and cognitive functioning (p = 0.039) which showed a significantly better score in the PCI arm. At three months, the observational arm scored significantly better on the EQ-VAS (median 70 vs 60, p = 0.017), while EQ-5D utility scores (Dutch tariff) were similar. At three months, QLQ-C30 showed that physical functioning, cognitive functioning, and global disease specific QoL were significantly better in the observational arm (median 83 vs 73, p = 0.003, median 100 vs 83, p = 0.006 and median 67 vs 67, p = 0.017). At later time-points, except for significantly better cognitive functioning at 24 months in the observational arm (median 83 vs 67, p = 0.017), no significantly different QoL (either QLQ-C30 or EQ-5D) was observed between the two arms.Table:Median scores of functional scales and global health status scores of QLQ-C30 and VAS and utility scores of EQ-5DMedian (PCI) Median (Observation) T0 T3 T12 T24 T0 T3 T12 T24 QLQ-C30 Physical 77 73 87 80 80 83 80 77 Role 67 67 67 67 67 67 67 67 Emotional 83 83 83 92 75 88 83 88 Cognitive 100 83 83 67 83 100 83 83 Social 83 83 100 83 83 83 83 92 Global QoL 67 67 67 67 67 67 67 67 EQ-5D Utility score 0.843 0.775 0.805 0.843 0.811 0.811 0.775 0.843 VAS score 65 60 70 75 70 70 69 70
Conclusions:
In conclusion, despite substantially reducing the incidence of brain metastases in NSCLC patients, PCI impairs short term generic QoL as well as disease specific QoL. The impact on long term QoL is limited to problems concerning cognitive functioning only.
Clinical trial identification:
Legal entity responsible for the study:
Nederlandse Vereniging van Artsen voor Longziekten en Tuberculose (NVALT)
Funding:
Has not received any funding
Disclosure:
All authors have declared no conflicts of interest.
Only Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login, select "Add to Cart" and proceed to checkout. If you would like to become a member of IASLC, please click here.
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Poster Display session (Friday) (ID 65)
- Event: ELCC 2018
- Type: Poster Display session
- Track:
- Presentations: 1
- Moderators:
- Coordinates: 4/13/2018, 12:30 - 13:00, Hall 1
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124P - Cardiac events in stage III non-small cell lung cancer (NSCLC): An attention shift to cardio-oncology collaboration (ID 587)
12:30 - 13:00 | Author(s): D. De Ruysscher
- Abstract
Background:
Recently it was shown that 15% of stage III NSCLC patients, treated with thoracic radiotherapy in dose-escalated trials, suffer from late cardiac events.[1] However, the prevalence of pre-existent cardiac co-morbidity in daily clinical practice in these patients and the development of cardiac events during follow-up is still unclear. As these patients are treated with curative intent and have a five survival rate 25%, there is need for a study to investigate the development of cardiac events and the relation with pre-existent cardiac co-morbidity.
Methods:
In this retrospective cohort study a thorough patient file search was carried out in 153 patients diagnosed with stage III NSCLC, treated with (chemo-)radiotherapy between 2006 and 2011 in our center. Primary endpoint was the incidence of pre-existing cardiac comorbidity and relation with the development of serious cardiac events, defined as CTCAE 4.0 grade >2, within five years after a curative treatment with (chemo)radiotherapy. Cardiovascular risk prediction was calculated for each patient according to WHO/ISH, which indicates the 10-year risk of a serious cardiovascular event.
Results:
Pre-existing cardiac comorbidity was seen in 46 patients (31.1%) with most frequently myocardial infarct/ coronary artery disease (9.8%) and arrhythmia (7.8%). WHO/ISH cardiovascular risk prediction was > 10% in 60.1% of the patients. Serious cardiac events appeared in 26% of the patients in the second year after treatment (20.3%). Most frequent cardiac events were arrhythmia (9.2%), myocardial infarction (6.5%), congestive heart failure (4.6%) and pericardial effusion (4.6%).Table:Serious cardiac events within subgroups of the study populationTotal N = 153 Cardiac history N = 46 No cardiac history N = 102 WHO/ISH Cardiac event risk > 10% N = 78 Cardiac events CTCAE-score > 2 (N/%) 38 (26%) 14 (30%) 24 (23%) 18 (23%) Missing (N) 7 - - - Median time to event 1–2 years (N/%) 17 (11.6%) 6 (13%) 11 (10.8%) 16 (20.5%)
Conclusions:
In daily clinical practice 1/3th of patients with stage III NSCLC, treated with (chemo-)radiotherapy, have pre-existing cardiac comorbidity. In addition, 26% develop a serious cardiac event during follow-up, even in patients without cardiac history. Therefor it is important to identify patients at risk in order to prevent these cardiac events.
Clinical trial identification:
Legal entity responsible for the study:
Maastricht University Medical Center
Funding:
Has not received any funding
Disclosure:
D. De Ruysscher: Consulting or advisory role to disclose: Bristol-Myers Squibb I have research funding to disclose: Brsitol-Myers-Squibb (BMS). A-M. Dingemans: Reports other from Roche/Genentech, other from MSD Oncology, other from AstraZeneca, other from Pfizer, other from Lilly, other from Boehringer Ingelheim, other from Bristol-Myers Squibb, other from Clovis Oncology, outside the submitted work. All other authors have declared no conflicts of interest.
