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Abdo Reem



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    P2.17 - Treatment of Locoregional Disease - NSCLC (Not CME Accredited Session) (ID 966)

    • 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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      P2.17-18 - A Prognostic Score for Patients Receiving Multimodal Treatment for Locally-Advanced Non-Small Cell Lung Cancer (ID 14198)

      16:45 - 18:00  |  Author(s): Abdo Reem

      • Abstract
      • Slides

      Background

      Background:

      Locally-advanced non-small cell lung cancer (LA-NSCLC) represents a heterogeneous entity, distinct regarding patient- and primary tumor features. Introduction of a simple prognostic score can lead to personalized decision-making in clinical routine. The present study aimed to create a prognostic score for LA-NSCLC patients treated with multimodal therapy.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      Patients and methods:

      Data were collated on a total of 100 patients treated with curative-intent multimodal therapy for LA-NSCLC (UICC stage III) . Several prognostic factors including gender, age, ECOG performance status, comorbidity, tobacco consumption, atelectasis before irradiation, COPD, emphysema and histology were analyzed for impact on overall survival (OS). Factors showing a significant negative association with OS on univariate analysis were included and scored with one point. A prognostic score was defined by the following 4 subgroups: low risk (0-1 points), medium risk (2 points), high risk (3 points) and very high risk (4-5 points).

      4c3880bb027f159e801041b1021e88e8 Result

      Results:

      Chemoradiotherapy (CRT) was completed by 96 (96%) patients with a total dose range of 50-70Gy. The absolute majority (81%) was treated with a total dose ≥ 60Gy. Intensity-modulated radiotherapy (IMRT) was delivered in 40 (40%) cases. 10 (10%) patients were treated with radiotherapy alone, 11 (11%) with sequential and 79 (79%) patients with concurrent CRT. 13 (13%) patients underwent surgery after completion of radiotherapy. Median OS for the entire cohort was 20.8 months (95% CI: 16.229–25.371). Impact on overall survival was found for age (negative in >60 vs. ≤60 years, p=0.038), gender (negative in male vs. female, p=0.016), pack years (PY) (negative in >21 PY vs. ≤20 PY, p=0.017), presence of atelectasis before irradiation (negative in yes vs. no, p=0.019) and tumor histology (negative in squamous cell carcinoma and NOS vs. adenocarcinoma, p=0.027).

      Per definition, 11 (11%), 26 (26%), 37 (37%) and 26 (26%) patients were in the low, medium, high and very high risk subgroups, respectively. Median OS was not reached for those with low risk, was 26.4 for medium, 22.0 for high and 13.7 months for patients with very high risk, respectively (p<0.001).

      8eea62084ca7e541d918e823422bd82e Conclusion

      Conclusion:

      The simple prognostic score we developed for patients receiving multimodal treatment for stage III NSCLC may aid physicians in making individual therapeutic decisions and personalizing treatment by defining patients with compromised survival outcomes.

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