Central Nervous System
PV QA 2 - Poster Viewing Q&A 2
Purpose/Objective(s): To compare the effect of whole brain radiation therapy alone (WBRT-A) versus whole brain radiation combined with local boost (WBRT-B) for small cell lung cancer (SCLC) with brain metastases (BM), and identify the prognostic factors.
Materials/Methods: A total of 350 consecutive SCLC with BM patients in our institution were retrospectively analyzed, from January 2000 to June 2017. Preliminary screening of the prognostic factors was accomplished by Kaplan–Meier univariate analysis. And survival curves between two groups were compared by log-rank test. The Cox regression model was used to analyze the multivariate prognosis.
Results: Median overall survival (OS) in WBRT-B group and WBRT-A group was 17.7 months (range,1.7~197.9 months) and 7.7 months (range,0.8~52.2 months), respectively. Univariate analysis showed that factors affecting OS were smoking, chemotherapy, GPA score, the number of intracranial metastasis and the number of extracranial organ metastasis (P <0.05). Multivariate analysis found that smoking (P = 0.030), GPA score (P = 0.032) and intracranial hypertension (P = 0.047) were independent prognostic factors affecting OS. Eighty-two patients were equally matched into WBRT-A group(n=41) and WBRT-B group(n=41) by propensity scores. After PSM, the survival benefit was found in the WBRT-B group compared with the WBRT-A group (P < 0.001).
Conclusion: Whole brain radiotherapy combined with local boost could improve OS for SCLC patients with BM. Also, smoking, GPA score and intracranial hypertension seemed to affect the OS.
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