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R. Zhang



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    Limitations and advances of thoracic radiotherapy (ID 58)

    • Event: ELCC 2018
    • Type: Proffered Paper session
    • Track:
    • Presentations: 1
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      131O - Radiotherapy improves the survival of patients with stage IV non-small cell lung cancer: A propensity matched analysis of surveillance, epidemiology, and end results database (ID 279)

      15:00 - 16:00  |  Presenting Author(s): R. Zhang

      • Abstract
      • Presentation
      • Slides

      Background:
      The survival advantage of radiotherapy (RT) for patients with stage IV non-small cell lung cancer (NSCLC) has not been adequately evaluated.

      Methods:
      We analyzed stage IV NSCLC patients enrolled from the Surveillance, Epidemiology, and End Results (SEER) registry through January 2010 to December 2012. Propensity score (PS) analysis with 1:1 nearest neighbor matching method was used to ensure well-balanced characteristics of all comparison groups by histological types and metastatic sites. Kaplan-Meier and Cox proportional hazardous model were used to evaluate the overall survival (OS) and cancer-specific survival (CSS).

      Results:
      There was a trend towards improved OS and CSS using radiotherapy to stage IV NSCLC patients for any metastatic sites and for any histological types except AD. Radiotherapy significantly improved the survival of NSCLC patients with metastasis to brain (P < 0.001), especially for adenocarcinoma (AD) (P < 0.001). For stage IV lung cancer patients with squamous cell carcinoma (SQC), radiotherapy for any metastatic sites could universally improve the OS (P < 0.001) and CSS (P < 0.001). In particular, radiotherapy also was associated with improved OS (P < 0.001) and CSS (P = 0.012) for stage IV patients with metastases of two or more site, i.e., poly-metastatic disease. Furthermore, for those stage IV SQC patients without metastasis, radiotherapy, most likely to the primary site, also significantly improved the survival (P < 0.001).

      Conclusions:
      The results support the idea that radiotherapy might improve the survival of patients with metastatic NSCLC in a PS-matched patient cohort from the large SEER database. It is prudent to carefully select patients for radiotherapy in metastatic NSCLC.

      Clinical trial identification:


      Legal entity responsible for the study:
      Dr. Zhenming Fu, Cancer Center, Renmin Hospital of Wuhan University, Wuhan, China

      Funding:
      National Science Foundation of China (NSFC)

      Disclosure:
      All authors have declared no conflicts of interest.

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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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      83P - Radiotherapy improves the survival of patients with extensive disease small cell lung cancer: A propensity matched analysis of surveillance, epidemiology and end results database (ID 281)

      12:30 - 13:00  |  Presenting Author(s): R. Zhang

      • Abstract
      • Slides

      Background:
      The survival advantage of radiotherapy (RT) for patients with extensive disease small cell lung cancer (ED-SCLC) has not been adequately evaluated.

      Methods:
      We analyzed stage IV SCLC patients enrolled from a large data from the Surveillance, Epidemiology, and End Results (SEER) registry through January 2010 and January 2012. Propensity score (PS) analysis with 1:1 matching and the nearest neighbor matching method were performed to ensure well-balanced characteristics of all comparison groups. Kaplan-Meier and Cox proportional hazardous model were used to evaluate the overall survival (OS), cancer-specific survival (CSS), and corresponding 95% confidence interval (95%CI).

      Results:
      Overall, for all metastatic ED-SCLC, receiving radiotherapy was associated with both improved OS and CSS. Generally speaking, radiotherapy for thoracic lesion and any metastatic sites could significantly improve the OS and CSS, except for brain metastasis. Before PS matching, radiotherapy significantly improved the survival of ED-SCLC patients with metastasis to brain (OS, HR = 0.71, with 95% CI = 0.61–0.83), however, the OS improvement became insignificant after PS matching (OS, HR = 0.91, with 95% CI = 0.74–1.12). For those M1a-SCLC patients without pleural effusion, radiotherapy, most likely to the primary site, also significantly improved the survival (P < 0.001). Furthermore, for those ED-SCLC patients with ≥ 2 metastatic sites, i.e., poly-metastatic ED-SCLC patients, radiation significantly improved the median OS from 6.0 months to 8.0 months (P = 0.015) and the median CSS from 7.0 months to 8.0 months (P = 0.020).

      Conclusions:
      The results suport radiotherapy in addition to chemotherapy might improve the survival of patients with metastatic ED-SCLC in a PS-matched patient cohort from the large SEER database. Although it should be adequately studied in phase III trials, it is prudent to select patients for radiotherapy in metastatic ED-SCLC.

      Clinical trial identification:


      Legal entity responsible for the study:
      Dr. Zhenming Fu, Cancer Center, Renmin Hospital of Wuhan University, Wuhan, China

      Funding:
      National Science Foundation of China (NSFC)

      Disclosure:
      All authors have declared no conflicts of interest.

      Only Active 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 or select "Add to Cart" and proceed to checkout.