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Andrew Turrisi Iii
OA13 - Therapeutics and Radiation for Small Cell Lung Cancer (ID 927)
- Event: WCLC 2018
- Type: Oral Abstract Session
- Track: Small Cell Lung Cancer/NET
- Presentations: 1
- Coordinates: 9/26/2018, 10:30 - 12:00, Room 203 BD
OA13.07 - Survival Outcomes After Whole Brain Radiotherapy for Brain Metastases in Elderly Patients with Newly Diagnosed Metastatic Small Cell Carcinoma. (ID 13900)
11:35 - 11:45 | Author(s): Andrew Turrisi Iii
Small cell lung cancer (SCLC) is an aggressive malignancy with a tendency to affect the elderly and to metastasize to the brain. However, elderly patients tolerate whole brain radiotherapy (WBRT) poorly with potentially detrimental effects on quality of life. Accordingly, the survival benefit of WBRT in this population is unclear. We utilized the national cancer database (NCDB) to evaluate the survival outcomes following WBRT in elderly patients with SCLC and brain metastases.a9ded1e5ce5d75814730bb4caaf49419 Method
We analyzed 1615 patients >75 years old diagnosed with SCLC and brain metastases at diagnosis. Patients were categorized by type of therapy: chemotherapy + WBRT (n=576), chemotherapy alone (n=238), WBRT alone (n=360) and no chemotherapy or WBRT (n=441). Clinical and demographic characteristics were reported for each treatment cohort with a subsequent multivariable regression analysis for survival. Propensity score-matching analysis was used for balance between comparison groups.4c3880bb027f159e801041b1021e88e8 Result
Median patient age was 79 years. 51% had brain-only metastatic disease. Whole brain radiation median dose delivered was 30 Gy (1.8-40 Gy). Median follow up was 2.8 months (0.03-68.01) for all patients. Of the patients included in this study, 1530 had died at time of analysis yielding a median OS of 2.9 months with 6 month and 1 year survivals of 31% and 12%, respectively.
For patients without chemotherapy, median OS with WBRT was 1.9 months compared to 1.2 months without WBRT (p<0.0001). For patients receiving chemotherapy with, and without WBRT, median OS was 5.6 months and 6.4 months, respectively (p=0.43). Multivariable cox regression revealed age >80, extracranial disease, male sex, and rural location as predictors of increased risk of death.
In elderly patients 75 years old or greater with SCLC brain metastasis, WBRT was associated with a modest increase in survival in patients not fit for chemotherapy, and there was no association with increased survival over chemotherapy alone.6f8b794f3246b0c1e1780bb4d4d5dc53