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Natalia Michaeli



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    P2.12 - Small Cell Lung Cancer/NET (Not CME Accredited Session) (ID 961)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/25/2018, 16:45 - 18:00, Exhibit Hall
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      P2.12-14 - Stereotactic Radiosurgery for Brain Metastases in Small Cell Lung Cancer. (ID 13726)

      16:45 - 18:00  |  Author(s): Natalia Michaeli

      • Abstract
      • Slides

      Background

      Prophylactic cranial irradiation (PCI) omission in favor of brain magnetic resonance imaging (MRI) staging and surveillance in the management of small cell lung cancer (SCLC) is controversial yet accepted by some centers policy. The latter strategy implies stereotactic radiosurgery (SRS) treatment (Tx) for limited brain metastases (BM). Data regarding SRS efficacy in this setting is limited.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      Ten consecutive SCLC patients (pts) with BM treated with SRS at Davidoff Cancer center between Aug 2012 and July 2017 were identified through the institutional database; pts receiving PCI or whole brain radiotherapy (WBRT) as a primary intervention were excluded. Brain MRI images were reviewed by neuro-radiology specialist. Intracranial objective response rate (IORR), progression-free survival (IPFS), intracranial failure patterns, overall survival (OS) and time-to-WBRT/death whichever occurred first (TTWD) were analyzed.

      4c3880bb027f159e801041b1021e88e8 Result

      Baseline pt characteristics are presented in the Table. SRS dose ranged from 16 Gy to 22.5 Gy. IORR comprised 57% by RECIST 1.1 and 60% by mRECIST 1.1. Intracranial progression developed in 8 pts; median IPFS was 3.9 mo (95% CI, 1.7-7.2). In-site, off-site and combined pattern of intracranial failure was seen in 0, 6, and 2 pts, respectively; median number of new BM per disease course was 2 (range, 1-11). Nine additional rounds of SRS were delivered in 6 pts (median number of lesion irradiated per round-1, range, 1-5). WBRT was ultimately administered in 3 pts; 4 pts died. Median TTWD comprised 23.2 mo (95% CI, 1.9-26.8). Median OS since SRS administration was 23.2 mo (95% CI, 4.2-26.8).
      table 1.jpg

      8eea62084ca7e541d918e823422bd82e Conclusion

      MRI surveillance combined with multiple rounds of SRS in case of limited BM development might provide reasonable alternative to PCI or therapeutic WBRT in SCLC. SRS in SCLC warrants prospective evaluation.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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