Abstract 2030
Background
The influence of the recurrence pattern on outcome of patients (pts) with stage III NSCLC following definitive chemo-radiotherapy (CRT) has been scarcely addressed in the literature. The aim of this study was to assess the relevance of oligoprogression (OP) in this clinical setting.
Methods
Pts diagnosed with stage III NSCLC who underwent concurrent CRT from 2010 to 2014 at the Catalan Institute of Oncology were retrospectively studied.The recurrence pattern at the first progression was recorded. OPwas defined as a single metastatic site with no more than 3 lesions. Overall Survival (OS),Progression-Free Survival (PFS) and Postprogression OS (PPOS) were plotted using the Kaplan Meiermethod and multivariate Cox proportional hazards models were developed.
Results
From 171 pts: median age 62 (37-81),male 87%; ECOG ≤ 1 92%; smoking status: current 49%, former 46%, never 5%; histology: adenocarcinoma (ADC) 34%,squamous (SCC) 43%, NSCLC (NOS + large cell) 23%; Stage:IIIA 51%, IIIB 49%; cN0-1 21%, cN2 60%, cN3 19%.Platinum doublet CT: Cisplatin 62%, Carboplatin 38%. Rate between 60 and 70 Gy:94%. At a median follow-up of 48months (m), 108 patients relapsed (63%), the mPFS was 13m (95% CI 10-16) and the mOS was 28m (95% CI 22-34). Recurrence pattern: Distant (D) 36%; Loco-regional (LR) 33%;both(LR + D) 30%.Twenty-five pts (23%) developed OP (48% ADC, 52% SCC) and the organs involved were17 visceral, 3 lymph nodes, 4 brain and 1 bone. Treatments performed in OP pts: 4 surgery, 4 stereotactic radiosurgery, 1 salvage CRT, 3 RT (WBRTx2 + 1 RTE 20 Gy), 9 CT, 4 none. From all pts who progressed (n = 108)mOS was 26m for those who received 2nd line treatment (n = 77,72%), vs 13m for those without treatment (p
Conclusions
In this cohort, the frequency of OP was remarkable and associated with improved OS. Pts with OP that might benefit from salvage therapies should be better characterized and proactively detected during follow-up after definitive CRT.
Clinical trial identification
Legal entity responsible for the study
Institut Català d'Oncologia
Funding
Institut Català d'Oncologia
Disclosure
All authors have declared no conflicts of interest.