Author of

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  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

  • 26155

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    MA22.10 - Prevalence and Risk Factors of Brain Metastases in Limited Stage Small Cell Lung Cancer Immediately Before Prophylactic Cranial Irradiation (ID 13185)

    16:20 - 16:25  |  Author(s): Xiao Chu
    • Abstract
    • Presentation
    • Slides

    Background
    

    Prophylactic cranial irradiation (PCI) reduces the incidence of brain metastasis (BM) and improves overall survival (OS) in limited-stage Small Cell Lung Cancer (LS-SCLC) patients with complete or partial remission after receiving chemoradiotherapy. However, cranial magnetic resonance imaging (CMRI) before scheduled PCI is not mandatory, and its necessity remains controversial. Therefore, we conducted this study to evaluate LS-SCLC patients’ BM rate revealed by CMRI immediately before PCI.

    a9ded1e5ce5d75814730bb4caaf49419 Method
    

    283 consecutive LS-SCLC patients diagnosed at our center between 2014 and 2017 were evaluated, all have negative base-line CMRI. Patients received platinum-based chemotherapy plus concurrent or sequential thoracic radiation. 119 complete or partial responders were identified. All received another CMRI immediately before PCI and constituted the cohort of interest. Logistic regression was employed to assess the relationship between pre-PCI BM risk and the following variables: age, gender, smoking history, lymph node stage or time from treatment initiation to pre-PCI MRI (TTPCI). Cox regression was employed to evaluate relations between these risk factors and OS. Two-sided P value <0.05 was considered statistical significant.

    4c3880bb027f159e801041b1021e88e8 Result
    

    25 out of 119 (21%) LS-SCLC patients developed pre-PCI BMs, TTPCI (2.83 to 13.03 months) was revealed as an independent risk factor for pre-PCI BM (risk ratio: 1.653, 95% CI: 1.312 – 2.084, P < 0.001, Table 1). Patients with pre-PCI BM have significantly shorter OS (hazard ratio: 1.653, 95% CI: 1.312 – 2.084, P < 0.001, Table 1).

    

    8eea62084ca7e541d918e823422bd82e Conclusion
    

    A considerable portion of LS-SCLC patients developed BM after definitive chemoradiotherapy and immediately before PCI. We recommend mandatory CMRI before PCI in these patients. Earlier scheduled PCI may reduce BM rate in selected LS-SCLC patients, further studies are warranted to determine the optimal PCI timing for LS-SCLC patients.

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