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Fiona McKay

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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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      193P - Management of cN2 NSCLC patients treated with radical radiotherapy: Relapse with or without brain metastases (ID 585)

      12:30 - 13:00  |  Presenting Author(s): Fiona McKay

      • Abstract


      The management and treatment of brain metastases (BM) is debated in NSCLC. SIGN guidelines state all cN2 patients should receive brain imaging prior to curative treatment. Furthermore NICE guidelines state those with a PS 0-1 should be offered palliative whole brain radiotherapy (RT) whilst the QUARTZ study recommends none. More recent advances in radiotherapy, surgery and chemotherapy may change this treatment paradigm. Therefore the aim of this study was to investigate the management of BM in a cN2 cohort of NSCLC patients treated with radical RT.

      a9ded1e5ce5d75814730bb4caaf49419 Methods

      Patients with NSCLC stage cN2 diagnosed from April 2013 to December 2016 treated with radical radiotherapy in the West of Scotland were identified. Electronic patient data was audited.

      20c51b5f4e9aeb5334c90ff072e6f928 Results

      In total 87 patients were identified to have received radical RT. The demographics are recorded in the table. Median Follow-up was 34 months from end of radiotherapy and overall survival was 14.4 months (95%CI 11.4-18.6 months). Overall 56 patients experienced relapse, 11 patients had brain relapse and median survival for this group was 4.0 m (2.0-upper bound not reached). For patients with other distant site of relapse median survival was 5.5 m (2.7-8.8 m). Regardless of site of relapse, there was a trend in survival by performance status when diagnosed with distant relapse (p = 0.012) – PS 1=8.8m, PS2=3.9m, and PS3=1.8m.

      fd69c5cf902969e6fb71d043085ddee6 Conclusions

      This study of cN2 NSCLC demonstrates that pre-treatment brain imaging was not performed as recommended for 80% of patients. The survival outcome for NSCLC cN2 patients treated with radical radiotherapy is poor compared with chemo-radiation. In this study, 69% of patients were of PS0-1, and hence it is not clear why chemotherapy was not given. Overall 64% of patients relapsed, of which 20% were diagnosed with BM, with median survival being no different to other sites of relapse. However, performance status at time of relapse was associated with better survival outcome.

      b651e8a99c4375feb982b7c2cad376e9 Legal entity responsible for the study

      The authors.

      213f68309caaa4ccc14d5f99789640ad Funding

      Has not received any funding.

      682889d0a1d3b50267a69346a750433d Disclosure

      All authors have declared no conflicts of interest.