Author of

• 36104

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  MA12 - Controversies Old and New (ID 230)

  • Event: WCLC 2020
  • Type: Mini Oral
  • Track: Small Cell Lung Cancer/NET
  • Presentations: 1
  • Moderators:
  • Coordinates: 1/31/2021, 16:45 - 17:45, Scientific Program Auditorium

  • 36108

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    MA12.06 - A Study of the Prognosis of Patients With Limited-Stage SCLC Who Did Not Receive Prophylactic Cranial Irradiation After Chemoradiotherapy (ID 957)

    16:45 - 17:45  |  Presenting Author(s): Xiao Hu
    • Abstract
    • Slides

    Introduction
    

    To evaluate the prognosis of small cell lung cancer (SCLC) patients who did not receive prophylactic cranial irradiation (PCI) after effective initial standard thoracic radiotherapy and chemotherapy.

    Methods
    

    Patients with limited-stage SCLC accrued in a prospective study were retrospectively analyzed. Those who had achieved complete remission (CR) or partial remission (PR) after radio-chemotherapy but did not receive PCI were selected. Kaplan Meier method was used to calculate survival data. The prognosis was analyzed using Cox proportional hazard regression model.

    Results
    

    Among 309 patients enrolled between June 2002 and January 2017, 275 patients achieved CR or PR after thoracic radiotherapy and chemotherapy, 82 patients did not receive PCI, 46 of them developed brain metastasis were analyzed in this study. The median time between brain metastasis and initial treatment was 5.5 months (2.9-26.6) and the median time between brain metastasis and the end of radiotherapy and chemotherapy was 1.7 months (0.2-24.0). Thirteen patients (28.3%) detected brain metastases before PCI, 24 patients (52.2%) had multiple brain metastases (≥ 3), 18 patients (39.1%) had symptomatic brain metastases, and 21 patients (45.7%) had control / slow progress of extracranial diseases. Thirty-three patients had complete treatment data for brain metastasis. Among them, 19 patients (57.6%) received brain radiotherapy alone, 4 patients (12.1%) received chemotherapy alone, 6 patients (18.2%) received brain radiotherapy and chemotherapy, and 4 patients (12.1%) did not receive treatment. The median survival time after brain metastasis was 7.0 months (95% CI: 4.6-9.3), and the overall survival rates of 1 year and 3 years were 32.6% and 3.3%, respectively. The median survival time of patients who received radiotherapy alone, chemotherapy alone and combined therapy were 8.3 months (4.7-11.8), 3.2 months (0.0-8.5), and 30.5 months (0.0-78.1) respectively (P = 0.000). Multivariate analysis showed that multiple brain metastases was a negative prognostic factors (HR: 3.59, 95% CI: 1.37-9.36, P = 0.009), brain radiotherapy (HR: 0.09, 95% CI: 0.02-0.37, P = 0.001), systemic chemotherapy (HR: 0.11, 95% CI: 0.02-0.61, P = 0.01) were favorably associated with overall survival.

    Conclusion
    

    Patients with SCLC who did not receive PCI tended to develop brain metastasis and had poor prognosis. PCI is highly recommended in patients who achieved CR and PR after thoracic radiotherapy and chemotherapy. Brain radiotherapy combined with chemotherapy could improve survival for patients with brain metastasis.

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