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Gizem Cosgun
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P2.18 - Treatment of Locoregional Disease - NSCLC (ID 191)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Treatment of Locoregional Disease - NSCLC
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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P2.18-07 - Prognostic Factors Affecting Brain Metastasis-Free Survival in Non-Small Cell Lung Cancer Patients (Now Available) (ID 2249)
10:15 - 18:15 | Author(s): Gizem Cosgun
- Abstract
Background
Brain metastasis is a poor prognostic factor for survival in all cancer types.Prophylactic cranial irradiation(PCI)has been considered standard of care for patients with small-cell lung cancer because of its favorable effects on survival, however there is no identifiable effect of PCI on survival in non-small cell lung cancer(NSCLC).The aim of this study is to define the factors which may be related to brain metastasis in patients with NSCLC who developed brain metastases after their definitive treatment.
Method
Two-hundred-eight patients with NSCLC,without brain metastases who received definitive radiotherapy or radiochemotherapy between January 2005 and January 2016 were evaluated retrospectively.Hematological parameters [platelet, neutrophil, lymphocyte counts, LDH, CRP, hemoglobin(Hb)levels,neutrophil-lymphocyte ratio(NLR)and platelet-lymphocyte ratio(PLR)],andFDG-PET/CT parameters(SUVmax values for the primary tumor and mediastinal lymph nodes),and patient characteristics were evaluated for brain-metastasis-free survival(BMFS).Cut-off values were determined byROC analysis.
Result
Patient and treatment characteristics were indicated in Figure 1. Median follow-up duration was 25 months.Cut-off values for platelet, NLR, PLR, LDH, CRP, and Hb were 290x103/µL, 2.6, 198, 468 IU/L, 2.5 mg/dL, and 11.5 g/dl. We defined each parameter as low or high according to the cut-off values. Fifty six patients(26.9%) developed brain metastases during follow-up.Median BMFS for the whole group was 21 months. In univariate analysis high NLR(71 vs 80months;p=0.001), PLR(71 vs 74months;p=0.037), LDH (65 vs 85months;p=0.028), CRP(47 vs 95months;p=0.002) values, SUVmax value ≥7.5 for lymph nodes(47 vs 79months;p=0.005) were poor prognostic factors for BMFS. In multivariate analysis high NLR(p=0.022), PLR(p=0.017), CRP(p=0.006), stage ≥IIIA disease(p<0.001), multi-stational N2 disease(p=0.036), adenocarcinoma histology(p<0.001) and SUVmax value ≥7.5(p=0.035) were poor prognostic factors for BMFS. Median survival duration after brain metastases was 6.5 months.
Conclusion
Development of brain metastases after definitive treatment of NSCLC is a serious problem affecting survival unfavorably. High NLR, PLR, LDH, CRP values and high SUVmax values for lymph nodes were additional prognostic factors besides stage, histology, and lymph node status.
