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Darijo Bokan
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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): Darijo Bokan
- Abstract
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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EP1.16 - Treatment in the Real World - Support, Survivorship, Systems Research (ID 206)
- Event: WCLC 2019
- Type: E-Poster Viewing in the Exhibit Hall
- Track: Treatment in the Real World - Support, Survivorship, Systems Research
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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EP1.16-40 - Communicating with Lung Cancer Patients in Eastern European Country: Topics of Interest (Now Available) (ID 1898)
08:00 - 18:00 | Author(s): Darijo Bokan
- Abstract
Background
Sincere and open communication about comprehensive lung cancer (LC) care is often avoided both by physicians and patients. Knowing the patients’ points of interest is of great importance for better provision of treatment and further planning of care. Aim of this pilot study was to assess the importance of selected topics for LC patients in order to provide a pathway for improvement of communication with patients.
Method
This prospective pilot study was conducted at the Institute for Pulmonary Diseases of Vojvodina, Serbia within a one Month period. Consecutive patients with advanced lung cancer in ECOG performance status 0-1 were included in this study regardless of lung cancer type and therapy regimen. Patients filled a questionnaire with 50 selected topics of interest and grading them based on importance using a on 5 point Likert scale. Topics were divided into following sections: diagnosis and prognosis, therapeutic options, care, rehabilitation, supportive and palliative care, psycho-oncology and spirituality. In the last question patients were asked to decide on length or quality of life (QoL).
Result
The total number of subjects included in this prospective study was 78. Out of total, 66.7% were male and 33.3% female. Average age of subjects was 64 (46-78). Section with topics about diagnosis and prognosis was rated with highest and the one about supportive and palliative care with lowest scores. We observed that topics of highest interest were the goal of therapy, effects of therapy and whether the cancer is curable. Among others most subjects in this study were willing to know more about duration of life when on therapy, how therapy will be applied and should they (and how) change life habits. Least important topics were ones about influence of therapy on sexual life, supportive and palliative care and accommodation in the nursing homes and palliative care units. Out of total, 53.8% of subjects chose quality over duration of life, 15.4% gave priority to life length and the rest (30.8%) could not decide. There were no differences between gender and age.
Conclusion
Advance communication skills should be equal with other (technical) medical skills. Comprehensive cancer care of LC patients starting from the diagnosis, promoting supportive and palliative care through open communication should be of great importance for all involved parties: patients and their family members and medical staff. Acknowledging important topics and introducing topics of interests for advanced cancer care planning can improve the QoL of LC patients.
