1294P - Definitive thoracic chemoradiotherapy in non-small cell lung cancer patients with solitary brain metastasis

Date 29 September 2012
Event ESMO Congress 2012
Session Poster presentation I
Topics Anti-Cancer Agents & Biologic Therapy
Non-Small-Cell Lung Cancer, Metastatic
Surgery and/or Radiotherapy of Cancer
Presenter Cem Parlak
Authors C. Parlak1, O.C. Guler2, O. Ozyilkan3
  • 1Baskent University Adana Medical Faculty, 01120 - Adana/TR
  • 2Department Of Radiation Oncology, Baskent University Adana Medical Faculty, 01120 - Adana/TR
  • 3Medical Oncology, Baskent University Faculty of MedicineAdana Uygulama Ve Arastirma Mer., TR-01120 - Adana/TR

Abstract

Background

The aim of the study was to evaluate the impact of definitive thoracic chemoradiotherapy on outcomes in non-small cell lung cancer (NSCLC) patients with solitary brain metastasis.

Materials and methods

Fifty four medically fit NSCLC patients with isolated BM were retrospectively evaluated. Patients were staged with PET-CT besides conventional staging tools. TRT to a total dose of 66 Gy in 2 Gy fx was delivered with 2 cycles of concomitant cisplatin –based chemotherapy (CT) following surgery + 30 Gy whole-brain RT (WBRT) (n:18), 30 Gy WBRT + 15 Gy boost (n:22), or 30 Gy WBRT + stereotactic radiosurgery (SRS) (n:14) for their BM. Response evaluation was done according to EORTC RECIST criteria

Results

Pretreatment patients characteristics were as given in Table 1. Overall the treatment was well-tolerated and all patients received planned TRT and 2 cycles of CT. At a median follow up of 15.2 months (4.4-42.3), median overall, locoregional progression free and progression free survivals were 12.2, 8.5 and 5.9 months. Univariate analyses revealed that patients receiving WBRT + SRS for BM (P < 0.001), performance status of ECOG 0-1 (P < 0.001), older than median age of 50 (p:0.031) no weight loss (p:0.001) had better survival. Multivariate analysis based on these factors demonstrated that all factors except age retained their independent prognostic values (p <0.05 for each).

Conclusion

Results of this study demonstrated that definitive T-CRT following WBRT + SRS for BM could improve poor prognosis in NSCLC patients with solitary BM. However, to make a firm conclusion, these findings should be validated by further prospective studies with larger cohorts.

Pretreatment patients characteristics

Characteristics Surgery + WBRT WBRT + BOOST WBRT + SRS P value
Median age (range) 52.3 (33-68) 50.4 (32-66) 48.3 (38-62) 0.57
Sex [N,(%)] Female Male 11 (20.4) 7 (13.0) 14 (25.9) 8 (14.8) 10 (18.5) 4 (7.4) 0.82
Performance status [N,(%)] ECOG 0-1 ECOG 2 14 (25.9) 4 (7.4) 11 (20.4) 11 (20.4) 11 (20.4) 3 (5.6) 0.25
Histology [N,(%)] Squamous cell Adenocancer 11 (20.4) 7 (13.0) 14 (25.9) 8 (14.8) 5 (9.3) 9 (16.7) 0.22
T Stage T1 T2 T3 T4 3 (5.6) 4 (7.4) 5 (9.3) 6 (11.1) 3 (5.6) 4 (7.4) 3 (5.6) 12 (22.2) 3 (5.6) 2 (3.7) 7 (13.0) 2 (3.7) 0.20
N Stage N0 N1 N2 N3 6 (11.1) 5 (9.3) 6 (11.1) 1 (1.9) 2 (3.7) 7 (13.0) 5 (9.3) 8 (14.8) 2 (3.7) 2 (3.7) 7 (13.0) 3 (5.6) 0.10
≥%5 weight loss [N,(%)] Yes No 9 (16.7) 9 (16.7) 12 (22.2) 10 (18.5) 5 (9.3) 9 (16.7) 0.54
Disclosure

All authors have declared no conflicts of interest.