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Dirk De Ruysscher



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    Mini Oral session III (ID 65)

    • Event: ELCC 2019
    • Type: Mini Oral session
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 4/12/2019, 17:45 - 18:45, Room C
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      86O - The effect of prophylactic cranial irradiation (PCI) for young stage III NSCLC patients: Subgroup analyses of the NVALT-11/DLCRG-02 study (ID 524)

      17:45 - 18:45  |  Author(s): Dirk De Ruysscher

      • Abstract
      • Presentation
      • Slides

      Background

      The NVALT-11/DLCRG-02 phase III study compared PCI to observation after chemo-radiotherapy (RT) for stage III NSCLC and showed a significant decrease in the cumulative incidence of symptomatic brain metastases (BM) in the PCI arm at two years (7% vs 27% [HR 0.23]). We here performed exploratory subgroup analyses.

      a9ded1e5ce5d75814730bb4caaf49419 Methods

      Two year cumulative incidence rates were calculated and competing risk regression, with death of any cause as competing risk, was used to examine the time to symptomatic BM in the following subgroups: age, gender, performance status, disease stage and tumour type, prior surgery, chemotherapy cycles, thoracic RT dose and total concurrent chemo-RT treatment time. For continuous variables, the median was used as a cut-off value. The effect of PCI was only examined if the initial result was significant.

      20c51b5f4e9aeb5334c90ff072e6f928 Results

      In total, 174 patients were analysed. The symptomatic BM incidence was significantly lower in the subgroup of older (>61 years) versus younger ( = <61 years) patients (7% vs 26% [HR 0.25]). Stratified by age, PCI only significantly reduced the symptomatic BM incidence in younger patients (9% vs 42% [HR 0.18])(Table).

      fd69c5cf902969e6fb71d043085ddee6 Conclusions

      The symptomatic BM incidence was significantly lower in older (>61 years) compared to younger ( = <61 years) patients, likely due to higher numbers of adenocarcinoma in the younger patients group. The effect of PCI was only significant in younger patients. This study was randomized based on treatment allocation and subgroups might be too small to detect significant differences. Therefore, our results are hypothesis generating and should be prospectively tested.

      b651e8a99c4375feb982b7c2cad376e9 Clinical trial identification

      NCT01282437.

      7a6a3ffa2dadc03a6151ee2c4d6fa383 Legal entity responsible for the study

      Nederlandse Vereniging van Artsen voor Longziekten en Tuberculose (NVALT).

      213f68309caaa4ccc14d5f99789640ad Funding

      Has not received any funding.

      682889d0a1d3b50267a69346a750433d Disclosure

      All authors have declared no conflicts of interest.

      cffcb1a185b2d7d5c44e9dc785b6bb25

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    My patient has stage IIIA (N2) disease: Surgery or radiotherapy? (ID 1)

    • Event: ELCC 2019
    • Type: Multidisciplinary Tumour Board
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 4/10/2019, 14:30 - 16:00, Room B
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      My patient needs chemoradiotherapy and durvalumab (ID 4)

      14:30 - 16:00  |  Presenting Author(s): Dirk De Ruysscher

      • Abstract
      • Presentation
      • Slides

      Abstract not provided

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