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Deepali Jain



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    Lunch & Poster Display session (ID 58)

    • Event: ELCC 2019
    • Type: Poster Display session
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 4/11/2019, 12:30 - 13:00, Hall 1
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      57P - Non-small cell lung carcinoma (NSCLC) patients with baseline brain imaging: A prospective observational study (ID 334)

      12:30 - 13:00  |  Author(s): Deepali Jain

      • Abstract
      • Slides

      Background

      Brain metastases in NSCLC patients is the major cause of the poor survival and quality of life. Symptomatic brain metastasis at baseline are present in 5-10% of NSCLC and over the time course about 40% patients develop brain metastasis. Screening for asymptomatic brain metastasis in advanced NSCLC is controversial. Here we present our initial experience of mandatory brain imaging of all NSCLC patients irrespective of CNS symptoms and stage.

      a9ded1e5ce5d75814730bb4caaf49419 Methods

      It is a prospective observation study of NSCLC patients with mandatory baseline brain imaging. Data was analysed for patients enrolled in the study from Jan 2018- Nov 2018. All patients with histology proven NSCLC were incuded irrespective of stage. Brain imaging was performed by CECT. A comprehensive CNS examination was performed at diagnosis. All statistical analysis was done by STATA version 13.Univariate analysis was done by Cox regression model.

      20c51b5f4e9aeb5334c90ff072e6f928 Results

      There were 238 patients enrolled. Median age was 58yrs (range 26-83yrs) with male predominance (n = 183 , 76.9%). Smokers were 65.1% ( n = 153) and majority had ECOG PS 1&2 (82%). Most common histology was adenocarcinoma - 64.6% (n = 151) . EGFR mutation could be tested in 98 of adenocarcinoma patients and was positive in 32 (32.6%). ALK (IHC-D5F3) was tested in 78 patients and was positive in 11 (14.1%) . Majority patients had stage 4 disease, 74.8% (n = 176). There was upstaging to stage 4 after brain imaging in 8% (n = 20) patients. Brain metastases was present in 22.7% (n = 54) of which 52% (n = 28) were asymptomatic. Majority had solitary lesion - 48% (n = 26), predominatly located supratentorially - 66% (n = 36). Majority of these patients received chemotherapy - 46.2% (n = 25), TKI -27.7% (n = 15), WBRT -14.8%(n = 8), BSC -22.2% (n = 12). Univariate analyses was done for age, sex, histological subtype, EGFR and ALK status, out of which younger age (<40 yrs) and adenocarcinoma histology were found to be significant predictors for presence brain metastases.

      fd69c5cf902969e6fb71d043085ddee6 Conclusions

      Brain metastasis with mandatory baseline brain imaging (atleast CECT) were found in 22.7% patients in our study and resulted in upstaging of disease in 8%. Frequency of brain metastasis were significantly higher in adenocarcinoma histology and younger age (<40 yrs).

      b651e8a99c4375feb982b7c2cad376e9 Legal entity responsible for the study

      All India Institute of Medical Sciences.

      213f68309caaa4ccc14d5f99789640ad Funding

      Has not received any funding.

      682889d0a1d3b50267a69346a750433d Disclosure

      All authors have declared no conflicts of interest.

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