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
1271 - A large scale prospective concordance study of oncogene driver detection between plasma- and tissue-based NGS analysis in advanced non-small cell lung cancer (NSCLC).
Presenter: Ryo Itotani
Session: Poster Display session 1
Resources:
Abstract
1132 - Biomarker status as a mediator of age-related overall survival (OS) in advanced non-small cell lung cancer (aNSCLC)
Presenter: Aaron Cohen
Session: Poster Display session 1
Resources:
Abstract
1502 - An exploratory analysis of on-treatment ctDNA measurement as a potential surrogate for overall survival for atezolizumab benefit in the OAK Study
Presenter: David Gandara
Session: Poster Display session 1
Resources:
Abstract
3912 - Disease monitoring of EGFR mutation-positive NSCLC patients via circulating tumor DNA
Presenter: Wei Fang Hsu
Session: Poster Display session 1
Resources:
Abstract
3856 - Incidence of T790M in NSCLC patients progressed to gefitinib, erlotinib, and afatinib: a study on circulating tumor DNA
Presenter: Romano Danesi
Session: Poster Display session 1
Resources:
Abstract
1330 - Folate receptor-positive circulating tumor cells as a predictive biomarker for the efficacy of first-line pemetrexed-based therapy in patients with non-squamous non-small cell lung cancer
Presenter: Xiaoxia Chen
Session: Poster Display session 1
Resources:
Abstract
3512 - Carcinoembryonic Antigen of Cerebrospinal Fluid Predict Prognosis of Leptomeningeal Metastasis from Non-Small Cell Lung Cancer
Presenter: Junjie Zhen
Session: Poster Display session 1
Resources:
Abstract
3852 - Liquid biopsy in clinical pratice of Non-Small-Cell-Lung Cancer (NSCLC): a multi-institutional experience
Presenter: Giovanna De Maglio
Session: Poster Display session 1
Resources:
Abstract
1205 - A Phase III Study Comparing SB8, a Proposed Bevacizumab Biosimilar, and Reference Bevacizumab in Patients with Metastatic or Recurrent Non-squamous NSCLC
Presenter: Martin Reck
Session: Poster Display session 1
Resources:
Abstract
2432 - Retrospective comparative study of the efficacy and safety in docetaxel and ramucirumab combination chemotherapy with or without previous immune checkpoint inhibitor treatment.
Presenter: Daijiro Harada
Session: Poster Display session 1
Resources:
Abstract