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Qing Dong



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    EP1.08 - Oligometastatic NSCLC (ID 198)

    • Event: WCLC 2019
    • Type: E-Poster Viewing in the Exhibit Hall
    • Track: Oligometastatic NSCLC
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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      EP1.08-01 - Whole-Brain Radiotherapy Plus Sequential or Simultaneous Integrated Boost for the Treatment of Limited Number of Brain Metastases in NSCLC (ID 871)

      08:00 - 18:00  |  Author(s): Qing Dong

      • Abstract
      • Slides

      Background

      There has been no definitive regimens on how to integrate whole brain radiotherapy(WBRT) and local boost for brain metastases(BMs). To compare the therapeutic effect and cerebral cognitive dysfunction in non-small cell lung cancer(NSCLC) patients with limited number of BMs (≤10) treated by WBRT plus sequential integrated boost (SEB) or simultaneous integrated boost(SIB).

      Method

      A total of 52 non-small cell lung cancer patients with limited number of BMs who underwent IMRT from January 2013 to December 2016 were retrospectively analyzed. 20 cases in group A were irradiated by WBRT+ SEB (first 3Gy*10Fx for WBRT then 4Gy*3Fx for BMs) and 32 case in group B were irradiated by WBRT+SIB(3Gy*10Fx for WBRT and the same 4Gy*10Fx for BMs). All patients had complete MMSE scores before radiotherapy, at the end of radiotherapy, 1 month after radiotherapy, 3 months after radiotherapy, and 6 months after radiotherapy. The clinical efficacy and differences in cognitive impairment were compared between 2 groups.

      Result

      The Cumulative survival rates of 1,2 and 3 years in 52 patients were 52.5%, 28.6% and 14.3%, respectively. The median survival time was 13 months. The Cumulative 1, 2 and 3-year survival rates of group A were 60.0%, 41.1%, 27.4%, respectively. The median survival time was 15 months. The 1,2 and 3-year survival rates of group B were 47.8%, 19.1%, 0%, respectively. The median survival time was 10 months. The effect difference between group A and B was significant (P=0.046). Subgroup analysis revealed that 1, 2 and 3 years survival rate and median survival time of group A were significantly superior to group B, especially to those patients with 1-2 BMs, male or age <60 years old (P<0.05). MMSE scores at the end of radiation and at 1 month after radiation were not significantly different from those before treatment in both group (P>0.05), however, the scores at 3 or 6 months after radiation were lower than before radiation, the difference was significant(P<0.05). There was no significant difference in MMSE scores in the 2 group before radiation, at the end of radiation, at 1 month after radiation and at 6 months after radiation (P> 0.05). The scores of group A at 3 months after radiation was higher than that of group B (P<0.05). Certainly, group A had longer radiotherapy time and more cost than group B (P<0.005).

      Conclusion

      For limited number of BMs in non-small cell lung cancer, WBRT+SEB is likely to be better than WBRT+SIB, especially to 1-2 metastases, male or aged <60 years patients. The decline of cognitive function in both groups occurred after 3 months of radiation, and WBRT+SEB group seems to be less impairment of brain cognitive function than that WBRT+SIB group. It is worth further study to verify Which boost scheme will be better.

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