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Poster session 04

959P - The association of GTV and brain metastasis development in patients with stage III NSCLC

Date

10 Sep 2022

Session

Poster session 04

Topics

Tumour Site

Non-Small Cell Lung Cancer

Presenters

Haiyan Zeng

Citation

Annals of Oncology (2022) 33 (suppl_7): S438-S447. 10.1016/annonc/annonc1063

Authors

H. Zeng1, Y. Willems2, F. Cortiula3, G. Bootsma4, A. Traverso5, D. De Ruysscher6, L. Hendriks7

Author affiliations

  • 1 Radiation Oncology, Maastro Clinic, 6229 ET - Maastricht/NL
  • 2 Department Of Radiation Oncology, Maastro Clinic, 6229 ET - Maastricht/NL
  • 3 Department Of Medical Oncology, ASU Friuli Centrale - Ospedale S. Maria della Misericordia, 33100 - Udine/IT
  • 4 Pulmonology, Zuyderland Medical Center, 6419 PC - Heerlen/NL
  • 5 Radiotherapy, Maastro Clinic, 6229 ET - Maastricht/NL
  • 6 Radiation Oncology Dep, Maastro Clinic, 6229 ET - Maastricht/NL
  • 7 Department Of Pulmonary Diseases, Grow - School For Oncology And Reproduction, Maastricht University Medical Center+, Maastricht, the Netherlands, 6229 HX - Maastricht/NL

Resources

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Abstract 959P

Background

To identify whether there is an association of gross tumor volume (GTV) and brain metastasis (BM) development in patients with stage III non-small cell lung cancer (NSCLC). Other potential risk factors were also investigated.

Methods

Retrospective multicenter study (4 Dutch, 1 Italian center). Included: patients with stage III NSCLC (staged with FDG-PET and brain MRI), treated with radical chemoradiotherapy (CRT). Excluded: participation in interventional clinical trial, other malignancy ≤5 years of NSCLC diagnosis; CRT after surgery. The time to BM was calculated from the date of pathological diagnosis to the date of imaging confirmed BM or last follow-up if no event was observed. Competing risk analysis was performed to identify risk factors for BM, in which death without BM was treated as competing event. Factors that were significant in the univariate analysis were included in the multivariate analysis.

Results

In total, 327 out of 506 patients were eligible, among which 55% were male. The median GTV was 71.06 cm3 (range: 4.9 – 1252.9). The median follow-up was 52.7 months (95% CI: 43.2-62.3), during which 193 (59%) patients died and 51 (15.6%) developed BM (84.3% symptomatic). The median overall survival was 30.8 months (95% CI: 24.1-37.5). Univariate analysis showed that females were at higher risk of developing BM (HR=2.02, 95% CI: 1.16-3.53, p=0.01); higher age (HR=0.94, 95% CI: 0.92-0.97, p<0.001) and squamous cell carcinoma (SCC) (HR=0.31, 95% CI:0.15-0.65, p=0.0017) were associated with a lower risk. GTV (HR=1.00, 95% CI=0.999-1.00, p=0.42) and other factors (Table) were insignificant (p>0.05). Multivariate analysis showed that higher age (HR=0.96, 95% CI: 0.93-0.98, p=0.002) and SCC (HR=0.42, 95% CI: 0.19-0.92, p=0.03) were independent protective factors for developing BM. Table: 959P

Clinical features and risk of BM

No./median (range) (N=327) Univariate Multivariate
HR (95% CI) p** HR (95% CI) p
Age 67 (35-88) 0.94 (0.92-0.97) <0.001 0.96 (0.93-0.98) 0.002
Gender
   M* 180 -
   F 147 2.02 (1.16-3.53) 0.01 1.34 (0.75-2.40) 0.32
Smoker
   Former/never* 182
   Current 140
BMI 25.1 (15.6-45.3)
   Underweight 15
   Normal* 129
   Overweight 105
   Obesity 47
   NA 31
PS
   0* 126
   1 171
   2 23
   3 4
   NA 3
Pathology
   SCC 126 0.31 (0.15 -0.65) 0.002 0.42 (0.19-0.92) 0.03
   NSCC* 201 -
T
   0-3* 180
   4 147
N
   0 36
   1 16
   2* 205
   3 70
Stage
   IIIa* 177
   IIIb 150
GTV 71.1 (4.3 – 1252.9)
Total RT dose 61.2 (14-74)
SER 56 (10-141)
RT duration 39 (4-66)
Timing of RT 15 (-73 ∼ 111)
CRT
   CCRT* 294
   SCRT 33
RT type
   ODRT* 207
   TDRT/mix 120

∗: reference ∗∗ reported if p<0.05

Conclusions

GTV was not significantly associated with the development of BM in patients with stage III NSCLC. Patients with non-squamous pathology and younger age were at higher risk to develop BM.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

MAASTRO.

Funding

Scholarship of China Scholarship Council (Grant No. : CSC 201909370087).

Disclosure

All authors have declared no conflicts of interest.

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