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M. Chandra

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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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      212P - Clinical experience and predictive factors of response to whole brain radiotherapy in metastatic lung cancer: A single institute experience (ID 462)

      12:30 - 13:00  |  Author(s): M. Chandra

      • Abstract

      Metastases in lung cancer especially to the brain is associated with poor outcomes and warrants palliative care in form of whole brain radiation therapy or best supportive care. Prognostic factors for overall survival are seen in many studies. However, there are few studies evaluating the role and predictive factors of whole brain radiation therapy (WBRT). The aim of this study was to identify the clinical outcomes and assess the predictive factors associated with treatment outcomes with WBRT in lung metastases.

      From 2009 to 2016, from medical records of Jupiter Hospital, 95 patients with histopathologically proven lung cancer and on imaging proven for solitary brain metastases, were evaluated retrospectively for demographic, treatment and clinical outcome parameters. Univariate and multivariate analysis were assessed for various impact of parameters in treatment outcomes age, Charlson comorbidity score, gender, marital status, use of chemotherapy, other metastatic sites, weight loss, BMI and edema and extent of edema/tumor ratio (E/T). T2 weighted and diffusion weighted images were assessed for the size comparison of E/T ratio.

      Poor outcomes were related to small cell lung cancer (p = 0.006), E/T ratio > 1.5 (p < 0.001), median tumor diameter <2 cm was associated with better prognosis. Low Charlson comorbidity score, male gender, presence of extra-cranial metastases, weight loss >10% and higher BMI were associated with poorer outcomes. On subset analysis as per the risk factors, median survival was 5.6 months’ vs 9.2 months in poor risk factors vs the better prognostic factors. Also, raised LDH was found to be closesly associated as a prognostic factor for inferior outcomes. Patients with SCLC exhibited an improved RR compared with patients with NSCLC.

      This study evaluates predictive factors for response of BMs to WBRT in lung cancer. In cases where outcomes are poor, they can be considered for best supportive care and these require quality of life assessments to predict outcome comparison. The patients with better prognostic factors can also be looked in to for higher dose delivery with boost to solitary metastases for better outcomes and needs to be assessed.

      Clinical trial identification:

      Legal entity responsible for the study:

      Has not received any funding

      All authors have declared no conflicts of interest.