Abstract 5315
Background
Brain metastasis (BM) is common among patients with non-small cell lung cancer (NSCLC). Whole brain radiotherapy (WBRT) plus a radiation boost is a common treatment strategy for such patients. WBRT plus simultaneous in-field boost (WBRT+SIB) and WBRT plus hypo-fractionated stereotactic radiotherapy (WBRT+FSRT) have shown promising outcomes. The current study compared the efficacy and safety of these two treatment strategies.
Methods
Sixty-six NSCLC patients with multiple BMs who met the inclusion criteria from January 2010 to December 2016 were enrolled. The efficacy and toxicity of WBRT+SIB and WBRT+FSRT were analyzed retrospectively. A Cox proportional hazard model was used to identify prognostic factors.
Results
The objective response rates in the WBRT+SIB and WBRT+FSRT groups were similar (74.9% and 79.4%, respectively; p = 0.5), as was the disease control rate (93.8% and 97.1%, respectively; P = 0.3). The median survival time was 15.3 months in the WBRT+SIB group and 25.2 months in the WBRT+FSRT group (p = 0.02). The median local progression-free survival was 13 months in the WBRT+SIB group and 17 months in the WBRT+FSRT group (p = 0.04). The incidence of 1-3 grade toxicity was slightly lower in the WBRT+FSRT group than the WBRT+SIB group (31.2% vs. 38.2%). Compared to the WBRT+SIB group, the WBRT+FSRT group was associated with a lower risk of mortality (HR = 0.6; 95% CI, 0.1-0.7) in the Cox multivariate model. Extracranial metastases, worse recursive partitioning analysis class, and non-surgical treatment of primary lesions were associated with a worse prognosis.
Conclusions
Compared to WBRT+SIB, WBRT+FSRT treatment was associated with a better prognosis and slightly less toxicity in patients with multiple BMs from NSCLC. Further studies are warranted to better elucidate the difference and determine the optimal dose/fractionation.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Jinyi Lang.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
1851 - Nivolumab-induced and radiation recall pneumonitis in patients with non-small cell lung cancer: a multicenter real world analysis of 669 patients
Presenter: Nobuaki Mamesaya
Session: Poster Display session 1
Resources:
Abstract
851 - Retrospective analysis of immunotherapy prognostic scores in advanced NSCLC at Nottingham University Hospitals (UK)
Presenter: Cristina Lopez Escola
Session: Poster Display session 1
Resources:
Abstract
3639 - Applicability of lung immune prognostic index (LIPI) to predict efficacy of first-line pembrolizumab in advanced non-small-cell lung cancer (NSCLC)
Presenter: Xabier Mielgo Rubio
Session: Poster Display session 1
Resources:
Abstract
2950 - Delayed Onset Immune Related Adverse Effects (IRAEs) of Pembrolizumab in Non-Small Cell Lung Cancer
Presenter: Haixi Yan
Session: Poster Display session 1
Resources:
Abstract
3659 - Clinical implication of multiplex IHC and serologic biomarkers on Hyperprogression in NSCLC patients receiving Immune checkpoint blockers in real world.
Presenter: Joori Kim
Session: Poster Display session 1
Resources:
Abstract
4882 - Local ablative treatment and treatment beyond progression for oligo-progression in stage IV non-small cell lung cancer after tumor response to anti-PD1 treatment
Presenter: Florian Guisier
Session: Poster Display session 1
Resources:
Abstract
1358 - Atezolizumab in combination with chemotherapy for first-line treatment of advanced non-small cell lung cancer: A systematic review and meta-analysis of randomized controlled trials (RCTs)
Presenter: Francis Mogollon-Duffo
Session: Poster Display session 1
Resources:
Abstract
2170 - Prognostic Impact of Metastatic Sites for Pembrolizumab Efficacy as First-line therapy in Patients with PD-L1 tumor proportion score (TPS) ≥ 50% Advanced Non–Small Cell Lung Cancer: A Retrospective Multicenter Study
Presenter: Hayato Kawachi
Session: Poster Display session 1
Resources:
Abstract
3051 - Impact of visceral fat area as independent predictive factor in patients with advanced non-small cell lung cancer treated with nivolumab
Presenter: Yuki Sato
Session: Poster Display session 1
Resources:
Abstract
3409 - Effect and safety of immune checkpoint inhibitors for brain metastases from non-small cell lung cancer
Presenter: Toshihiko Iuchi
Session: Poster Display session 1
Resources:
Abstract