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Susana Padrones-Sánchez
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P1.18 - Treatment of Locoregional Disease - NSCLC (ID 190)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Treatment of Locoregional Disease - NSCLC
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/08/2019, 09:45 - 18:00, Exhibit Hall
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P1.18-03 - How to Predict High Grade Radiation Pneumonitis in Non-Small Cell Lung Cancer Patients Treated with Thoracic Radiotherapy (Now Available) (ID 835)
09:45 - 18:00 | Author(s): Susana Padrones-Sánchez
- Abstract
Background
Predictive factors of radiation pneumonitis (RP) have been studied without conclusive results. The aim of this retrospective study was to identify clinical, inflammatory or dosimetric factors that could predict the development of high grade RP (HGRP).
Method
A retrospective analysis was conducted in patients with non-small cell lung cancer (NSCLC) treated with concurrent chemo- radiotherapy, secuential chemo-radiotherapy or radiotherapy (RT) alone at the Catalan Institute of Oncology from 2012 to 2016 who developed symptomatic RP. Collected variables were: anthropometric values, Neutrophil-Lymphocyte Ratio (NLR), Platelet-Lymphocyte Ratio, lung function, tumor features (histology, localization, staging) and treatment characteristics. RP was classified using RTOG scale. Patients were divided in 2 groups (low-grade [G1-G2], and HGRP [G3-G5]). Multivariate and regression tree analysis were performed.
Result
Sixty-seven patients were identified: 61% had low-grade RP and 39% HGRP. Development of HGRP was only associated with RT total dose (p=0.045). The most relevant predictive factors of HGRP were tumor location in lower lobes, high NLR values and the presence of peripheral vasculopathy. Figure 1 shows, when tumor is located in lower lobes and NLR is > 2.75, the probability of HGRP was 70% vs 50% when NLR <2.75. In other locations with NLR >4.56 the probability to develop a HGRP was 62%. But, when NLR<4.56, the presence of peripheral vasculopathy and its treatment determine the development of HGRP. When vasculopathy was not treated the probability to develop HGRP was 36% vs 0% when it was treated.61% had low-grade RP and 39% HGRP. Development of HGRP was only associated with RT total dose (p=0.045). When cancer is localized in lower lobes and NLR is > 2.75 the probability to develop HGRP was 70% vs 50% when NLR <2.75. In other locations with NLR >4.56 the probability to develop a HGRP was 62%. But, when NLR<4.56, the presence of vasculopathy and its treatment determine the development of HGRP. When vasculopathy was not treated the probability to develop HGRP was 36% vs 0% when it was treated.
Figure 1. Probability to develop HGRP (G3 –G5)
Conclusion
The probability of develop HGRP has been associated with RT dose and the association of cancer location, NLR, presence of vasculopathy and its treatment.
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P2.17 - Treatment of Early Stage/Localized Disease (ID 189)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Treatment of Early Stage/Localized Disease
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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P2.17-10 - Effects of the Omega-6/Omega-3 Ratio on Postoperative Complications After Lung Resection: Preliminary Results (ID 1862)
10:15 - 18:15 | Author(s): Susana Padrones-Sánchez
- Abstract
Background
In the last 3 decades, the intake of omega-6 (n-6) fatty acids has increased while the intake of omega-3 (n-3) has decreased, leading to an increase in the n-6/n-3 ratio, which is now 20:1. This ratio has been postulated as an inflammatory marker of carcinogenesis, implicated in the development of multiple chronic diseases, and associated with postoperative complications due to the proinflammatory effects of omega 6. Consequently, the preoperative assessment of nutritional markers, together with immunonutrition, represent a promising target to improve outcomes in patients with lung cancer who are candidates for surgical resection. The aim of this study was to assess the effect of the n-6/n-3 ratio on postoperative complications in patients undergoing radical-intent surgery for lung cancer.
Method
Prospective cohort study of 38 patients diagnosed with lung cancer treated with radical surgery between October 2017 and May 2018. The n-6/n-3 ratio was determined immediately prior to surgery with the patient under anesthesia.
Result
Of the 38 surgically-treated patients, 29 were men (76%) and 9 women (24%). Mean patient age was 62 ±10 years. Twelve (32%) patients were active smokers at the time of surgery. The most common histological subtype was adenocarcinoma (60%) and most patients underwent lobectomy (68%). The mean body mass index (BMI) was 27 ±5 and the mean preoperative prognostic nutritional index (PNI) score was 48±7. The mean n-6/n-3 ratio was 20 ±6. The most common complications were prolonged air leak (> 5 days) in 11 patients (29%) and respiratory failure in 6 patients (16%). Patients with prolonged air leak had a significantly higher n-6/n-3 ratio than patients without prolonged air leak (25 ±3 vs. 18 ±6, respectively; p=0.02). Patients with an n-6/n-3 ratio > 20 were significantly more likely (p=0.002) to present prolonged air leak. Neither BMI nor PNI were significant predictors of air leak duration.
Conclusion
These preliminary findings indicate that patients with a higher n-6/n-3 ratio—that is, those with a greater proinflammatory status—were more likely to present prolonged air leak than those with a lower inflammatory status. Based on these encouraging results, we propose to continue with this line of research to better understand the effects and prognostic value of immunonutritional status on the clinical course of patients after lung cancer surgery.
