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Nevena Secen



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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
    • Now Available
    • Moderators:
    • Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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      EP1.12-04 - Can Prophylactic Cranial Irradiation Reduce Neurological Symptoms in Patients with Small Cell Lung Cancer? (Now Available) (ID 1428)

      08:00 - 18:00  |  Author(s): Nevena Secen

      • Abstract
      • Slides

      Background

      The central nervous system is the usual site of metastasis in patients with small cell lung carcinoma (SCLC). Despite advances in combined treatment modalities, it’s the main cause of morbidity in these patients. High prevalence of brain metastases, combined with the poor intracranial penetration of most chemiotherapy regimens used, led to development of prophylactic cranial irradiation (PCI), a preventive radiotherapeutic treatment, which has been shown to be effective in reducing the incidence of brain metastases. Earlier studies showed that patients who had PCI, had reduced rate of symptomatic brain metastasis at one year (14.6% vs 40.4%) and had slightly better overall survival. In Institute for pulmonary diseases of Vojvodina, there are around 1200 newly diagnosed patients with lung cancer in each year, of which around 200 patients (14%) have SCLC. PCI is now routinely administered to patients with SCLC, after a complete/partial response to initial treatment.

      Method

      This was a retrospective study conducted at the Institute for Pulmonary Diseases of Vojvodina, Serbia, which included patients diagnosed with SCLC in this institution, between October 2015 - October 2017. The patients were divided into two groups, one who received PCI after complete/partial answer to systemic therapy and chest irradiation, total of 34 patients. The control group consisted of 30 patients, who also had good answer to systemic therapy and chest radiation therapy, but didnt receive PCI.

      Result

      In this study, significantly higher percentage of patients in the PCI group (84.8% vs 40.0%) didn’t develop neurological symptoms (p= 0.000). In the group of patients who received PCI, only 5 out of 34 (14.7%) developed CNS symptoms, an average of 10 months after completing the PCI. In the control group, 60% (18/30) of patients experienced neurological symptoms, on average 11 months after diagnosis. Data analysis found that patients in PCI group were 8.4 times less likely to develop neurological symptoms. Also, it was confirmed that overallsurvival was better for patients who received PCI after systemic and irradiation treatment, the mean OS of patients in the PCI group was 19.0 months, compared to the control group where it was 15.4 months.

      Conclusion

      The authors strongly believe that PCI should remain a standard of care for patients with SCLC, after response to initial treatment. If not only for prolonging the overall survival, but also because it improves the quality of life in these patients by reducing the neurological symptoms.

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