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Oliver Coen
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P2.01 - Advanced NSCLC (ID 618)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 10/17/2017, 09:00 - 16:00, Exhibit Hall (Hall B + C)
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P2.01-060 - Outcomes Following Gamma Knife Radiosurgery in Patients with Non-Small Cell Lung Cancer with Brain Metastases (ID 8056)
09:00 - 16:00 | Presenting Author(s): Oliver Coen
- Abstract
Background:
Gamma knife (GK) radiosurgery is a common treatment for brain metastases from non-small cell lung cancer (NSCLC). This study reports outcome results for patients with synchronous brain metastases and delayed brain metastases from NSCLC at Leeds Cancer Centre (LCC).
Method:
Data was obtained by retrospective case note review for 72 patients, who were all treated with GK from 2009 until 2014. Radical thoracic therapy (surgery, chemoradiotherapy or stereotactic ablative radiotherapy) was also undertaken for 58 patients. Statistical analysis using Kaplan-Meier curves was performed to estimate time to intracranial progression, survival from diagnosis of brain metastases, and overall survival.
Result:
Demographic data identified a median age of 65 years (range 43 – 83 years). For patients with delayed brain metastases (47 patients), TNM stage at diagnosis was stage I (7 patients), stage II (11 patients), stage IIIA (12 patients) or stage IIIB/IV (17 patients). Histology was majority adenocarcinoma (50%) or squamous cell carcinoma (22%). The median time to intracranial progression for all patients treated with GK was 9 months. In patients treated with radical thoracic therapy, of which 88% completed treatment, the median survival from diagnosis of brain metastases was 15 months for those with synchronous brain metastases (18 patients), and 14 months for those with delayed brain metastases (40 patients). In those with synchronous brain metastases, 83% received GK prior to radical thoracic therapy (median survival 18 months vs. 14 months for delayed GK). In those with intracranial progression following GK prior to death, 25% were treated with salvage GK with a median survival of 23 months. This compares to 18 months for those treated with salvage whole brain radiotherapy and 8 months for those not suitable for salvage treatment. The overall median survival for patients treated with combination radical thoracic therapy and GK at LCC was 21 months (median survival in synchronous brain metastases at diagnosis = 16 months vs. median survival in delayed brain metastases = 27 months).
Conclusion:
In conclusion, GK radiosurgery is an effective treatment for brain metastases in NSCLC. Beneficial effects are seen in patients with synchronous and delayed brain metastases, demonstrating its role in a wide subset of patients with advanced NSCLC. Use of GK, in combination with radical thoracic therapy, therefore has the potential to dramatically improve survival in patients who may not have previously been suitable for radical treatment.
