Virtual Library

Start Your Search

Alysa Fairchild



Author of

  • +

    MA22 - New Therapeutics, Pathology, and Brain Metastases for Small Cell and Neuroendocrine Tumour (ID 925)

    • Event: WCLC 2018
    • Type: Mini Oral Abstract Session
    • Track: Small Cell Lung Cancer/NET
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/25/2018, 15:15 - 16:45, Room 206 BD
    • +

      MA22.09 - Should Stereotactic Radiosurgery be Considered for Salvage of IntracranialĀ Recurrence in Small Cell Lung Cancer? (ID 14092)

      16:15 - 16:20  |  Author(s): Alysa Fairchild

      • Abstract
      • Presentation
      • Slides

      Background

      Prophylactic cranial irradiation (PCI) remains a standard of care for small cell lung cancer (SCLC) to improve overall survival (OS) and prevent recurrence in limited (LS) and extensive stage (ES) disease. Intracranial recurrence (IC) after PCI affects 12-33%. Limited published data describe outcomes of salvage reirradiation (ReRT). Our purpose was to review outcomes after IC post-PCI or therapeutic whole brain radiotherapy (WBRT).

      a9ded1e5ce5d75814730bb4caaf49419 Method

      Consecutive patients with pathologically-confirmed SCLC assessed (01/2013-12/2015) at a tertiary cancer centre (catchment 1.5M) were retrospectively reviewed. Demographics, treatment and outcomes were abstracted and summary statistics calculated. Kaplan-Meier estimates and univariate and multivariate analysis (MVA) via the Cox proportional hazard model were performed.

      4c3880bb027f159e801041b1021e88e8 Result

      Median age was 66.1yrs, 53% female, and 80% ECOG 0-2 (N =372). Median survival (MS) was 24 months (95%CI 18.3-29.7 mos) for 103 LS, and 7 months (95%CI 6.1-7.9 mos) for 269 ES patients. 72/103 LS received PCI (69.9%), 84.7% of whom had radical thoracic radiotherapy (RT). 54/269 ES patients presented with brain metastases (BM); 98/215 of the remaining received PCI, and 72 of those thoracic RT (84.7% 25-30Gy/10). PCI dose was 25Gy/10 in 95.9%. PCI patients had better performance status (PS), and were more likely to receive chemotherapy (CT) and thoracic RT (all p<0.013). 18.8% (32/170) recurred post-PCI (13 LS; 19 ES) at a median of 11.5 mos. 45/54 presenting with BM received WBRT (83.3% 20Gy/5), 14 of whom recurred. MS after PCI was 28 mos vs 12 mos for LS and ES, respectively. For LS patients with IC post-PCI, MS was 20 mos vs 38 mos without IC (p=0.03). On MVA, interval between brain RT predicted OS after PCI (HR 0.87; p<0.001), while stage (HR 3.56; p=0.008) and cranial RT dose predicted IC (HR 0.65; p=0.047). At IC, 56.5% (26/46) had <5 BM, median 1.7cm (range 0.5-5cm), 39.1% had no extracranial disease, 6 were asymptomatic, and 50% had ECOG 0-2. 30/46 had ReRT: 27 WBRT and 3 stereotactic radiosurgery (SRS). In retrospect, 17/46 would have been candidates for salvage SRS: 5 LS post-PCI; 8 ES post-PCI; and 4 ES post-WBRT.

      8eea62084ca7e541d918e823422bd82e Conclusion

      This cohort seems to challenge the belief that in-brain progression is always: diffuse; associated with clinical deterioration; and synchronous with systemic failure. With potential for OS >6 months, repeat WBRT risks meaningful neurocognitive toxicity. Further data are required; however, approximately 1 in 3 SCLC patients who recur after PCI or WBRT appear clinically appropriate for salvage SRS.

      6f8b794f3246b0c1e1780bb4d4d5dc53

      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.

      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.

  • +

    MA25 - Oligometastasis: Defining, Treating, and Evaluating (ID 929)

    • Event: WCLC 2018
    • Type: Mini Oral Abstract Session
    • Track: Oligometastatic NSCLC
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/26/2018, 13:30 - 15:00, Room 203 BD
    • +

      MA25.08 - Discussant - MA 25.05, MA 25.06, MA 25.07 (ID 14602)

      14:15 - 14:30  |  Presenting Author(s): Alysa Fairchild

      • Abstract
      • Presentation
      • Slides

      Abstract not provided

      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.

      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.