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ESRA Gumustepe
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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
- Now Available
- Moderators:
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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EP1.08-03 - Results of Definitive Treatment in Patients with Synchronous Oligometastatic Non Small Cell Lung Cancer (Now Available) (ID 2444)
08:00 - 18:00 | Author(s): ESRA Gumustepe
- Abstract
Background
To evaluate the prognostic factors and outcome of both thoracic radiotherapy (RT) and oligometastasis treatment with curative intent in cases with oligometastatic non-small lung carcinoma (NSCLC).
Method
We retrospectively evaluated 18 synchronous oligometastatic NSCLC patients who underwent radical treatment in the thoracic and oligometastasis region between 2015 and 2018 in our center.
Result
The median age of patients was 62 years. Only two of 18 patients had ≥2 organ involvement. Patients' clinical and treatment characteristics are summarized in Table-1 and Table-2. Median follow-up was 7 months. The median overall survival (OS) was 11 months and the median progression-free survival (PS) was 8 months. The one year OS and PS was found 45% and 50% respectively. In the univariate analysis, the localization of oligometastasis (brain vs other distant met) was found as an effective factor on OS. The median survival was found to be 7 months in patients with brain metastasis whereas 18 months in patients with other metastasis. Although treatment type (RT vs surgery) or RT technique applied for oligometastasis (Conformal RT (3DCRT)/IMRT vs Stereotactic RT (SRS/SBRT)) did not cause significant difference on OS in univariate analysis; in the multivarian analysis, the localization of oligometastasis (HR: 7.3, 95% CI 1.33-40.5) and the RT technique applied for oligometastasis (HR: 8.45, 95% CI 1.43- 49.9) were found to be prognostic factors on OS (p = 0.012). In the univariate analysis induction chemotherapy (CT) and RT tecnique were statistically significant for PS, but this significance could not be demonstrated in multivarian cox regression analysis.
Table.1:Demographic characteristics of patients and the results in univarian analysis
Number (%) p value (OS) p value (PS) Age (years)
median (min-max)
<60 years
≥ 60 years61.5 (35.0-73.0)
7 (38.9)
11 (61.1)0.725 0.355 Gender
Male
Female16 (89.0)
2 (11.0)0.786 0.876 Histology
Adenocarcinoma
SCC12 (67.0)
6 (33.0)0.145
0.785 T stage
T1
T2
T3
T4
Unknown3(17.0)
4(22.0)
4(22.0)
6(33.0)
1(6.0)
0.87 0.369 N stage
No
N1
N2
N3
Unknown4(22.0)
5(28.0)
8(44,0)
0(0)
1(6.0)0.169 0.222 Table 2: Treatment characteristics of patients and the results in univarian analysis
Number (%) p value (OS) p value (PS) RT region
Brain
Bone
Surrenal
Liver
Other7 (50)
3 (21)
1 (7)
1 (7)
2 (15)0.299 0.021 Metastasis number
1
2
3-5
12 (66.0)
3 (17.0)
3 (17.0)0.393 0.794 Metastatic organ
Brain
Other
Bone
Surrenal
Liver
Multiple
Other7 (39.0)
11(61.0)
3 (17.0)
3 (17.0)
1 (5.0)
2 (11.0)
2 (11.0)
0.031 0.421 Oligometastasis treatment
Surgery
RT
Surgery and RT
4 (22.0)
10 (56.0)
4 (22.0)0.412 0.534 Oligometastasis RT tecnique
SRS/SBRT
1x20 Gy
5x5 Gy
3DCRT/IMRT
3x 10 Gy
3x 15 Gy4 (28.5)
3
1
10 (72.5)
6
40.065 0.468 Thoracic RT Dose
45
60
64-66
4 (22.0)
5 (28.0)
9 (50.0)0.194 0.536 Induction CT
Yes
No11(61.0)
7 (39.0)0.067 0.044 Concurrent CT
No
Yes
6 (33.0)
12 (67)
0.084 0.142
Results of treatment with thoracic RT and oligometastasis region in oligometastatic NSCLC seem promising. The localization of the oligometastasis and the technique of RT are important factors.