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Mengyuan Chen
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EP1.12 - Small Cell Lung Cancer/NET (ID 202)
- Event: WCLC 2019
- Type: E-Poster Viewing in the Exhibit Hall
- Track: Small Cell Lung Cancer/NET
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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EP1.12-35 - Comparison of Long Term Results Between Matched Chemoradiotherapy and Surgery for Limited Stage Small Cell Lung Cancer (ID 247)
08:00 - 18:00 | Presenting Author(s): Mengyuan Chen
- Abstract
Background
The role of surgery in patients with SCLC is undefined. Our study was conducted to compare the long term results of chemoradiotherapy with surgical treatment for limited stage SCLC.To compare the efficacy of chemoradiotherapy or surgery for limited-stage small cell lung cancer (SCLC).
Method
A retrospective analysis was performed on 138 patients with limited-stage SCLC who received surgery (69 patients) or chemoradiotherapy (69 patients) between January 2000 and September 2016 in Zhejiang Cancer Hospital. Patients of the chemoradiotherapy group were selected by using ‘pair-matched case-control’ methodology from a cohort of 503 patients who received chemoradiotherapy.
Result
The major prognostic factors including T, N stage, treatment duration, age, gender, and whether or not received prophylactic cranial irradiation were well balanced between two groups. The median overall survival (OS) time and 5-year OS rate were 37.1 months and 45.0% in surgical group versus 45.0 months and 45.0% in chemoradiotherapy group (P=0.846). The median progression-free survival (PFS) time and 5-year PFS rate were 27.1 months and 37.8% versus 36.2 months and 40.0% respectively in the two groups (P=0.610). The 5-year OS rate (62.3% vs. 40.1%, P=0.038) and 5-year PFS rate (80.1% vs. 40.1%, P=0.048) in surgical group were significantly higher than those of chemoradiotherapy group in patients with stage I disease. While the 5-year OS rate (41.2% vs. 50.6%, P=0.946), 5-year PFS rate (64.7% vs. 42.1%, P=0.280) of surgery for stage II SCLC were comparable to chemoradiotherapy. As for stage III SCLC, compared with the surgical group, the chemoradiotherapy group had a better 5-year OS trend (25.1% vs. 47.6%, P=0.220).
Conclusion
Surgery could confer survival benefit in patients with p-stage I disease, but not in patients with p-stage II and III disease.
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P1.12 - Small Cell Lung Cancer/NET (ID 179)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Small Cell Lung Cancer/NET
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2019, 09:45 - 18:00, Exhibit Hall
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P1.12-12 - Factors Affecting the Risk of Brain Metastasis in Limited-Stage Small Cell Lung Cancer After Prophylactic Cranial Irradiation (ID 243)
09:45 - 18:00 | Presenting Author(s): Mengyuan Chen
- Abstract
Background
Prophylactic cranial irradiation (PCI) can reduce brain metastases (BM) and improve overall survival (OS) in patients with limited-stage small cell lung cancer (LS-SCLC) after complete response to primary therapy. However, some SCLC patients still suffer from BM after PCI with unknown risk factors.This study conducted to assess the factors affecting the risk of BM in patients with LS-SCLC after PCI and identify characteristics of patients who may not benefit from PCI.
Method
We identified 550 patients who received chemoradiotherapy at Zhejiang Cancer Hospital in 2002–2017. All patients received PCI. Kaplan–Meier analyses and Cox regression analyses were used to identify factors influencing OS and BM.
Result
The median survival time for this patient population was 27.9 months, and the 5-year overall survival rate was 31%. Pathologic stage not only correlated with overall survival but also significantly affected the risk of BM. For the whole group, 15.6% (86/550) of the patients had evidence of metastases to brain. The frequency of BM in patients with pathologic stages I, II, and III were 9.3% (4/43), 13.4% (7/52), and 16.5% (75/455), (P=0.026), Having tumors ≥5 cm increased the risk of BM (HR: 1.781 95%CI：1.044-3.039, P=0.034) but not death (HR:1.126 95%CI：0.925-1.663, P=0.182). The median survival time among patients ＜60 years were significantly higher than patients ≥60 years (34.9 months VS. 24.6 months，P=0.001)，however, the difference of the BM risk in two group was not statistically significant.
Conclusion
PCI remains standard therapy after complete response to chemoradiotherapy for LS-SCLC. However, patients with tumors ≥5 cm may have a higher risk of developing brain metastases after PCI. Further work is warranted to identify patients who may not benefit from PCI.
