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MO_14_2814 - Whole-Brain Radiation Therapy Plus Sequential or Simultaneous Integrated Boost for the Treatment of Finite Number of Brain Metastases in Non-Small Cell Lung Cancer

Monday, October 22
10:45 AM - 12:15 PM
Location: Innovation Hub, Exhibit Hall 3

Whole-Brain Radiation Therapy Plus Sequential or Simultaneous Integrated Boost for the Treatment of Finite Number of Brain Metastases in Non-Small Cell Lung Cancer
D. Y. Ma, D. Qing, B. Zhao, Y. C. Zhou, and H. L. Zhu; Department of Oncology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China

Purpose/Objective(s): There has been no definitive regimens on how to integrate whole brain radiotherapy(WBRT) and local boost for brain metastatas(BMs). To compare the therapeutic effect and cerebral cognitive dysfunction in non-small cell lung cancer patients with finite number of BMs (≤10) treated by WBRT plus sequential integrated boost (SEB) or simultaneous integrated boost(SIB).

Materials/Methods: A total of 52 non-small cell lung cancer patients with finite number of BMs who underwent IMRT from January 2013 to December 2016 were retrospectively analyzed. 20 cases in group A were irradiated by WBRT+ SEB ( first 3Gy*10Fx for WBRT then 4Gy*3Fx for BMs) and 32 case in group B were irradiated by WBRT+SIB(3Gy*10Fx for WBRT and the same 4Gy*10Fx for BMs). The clinical efficacy and differences in cognitive impairment were compared between 2 groups.

Results: The Cumulative survival rates of 1,2 and 3 years in 52 patients were 52.5%, 28.6% and 14.3%, respectively. The median survival time was 13 months. The Cumulative 1, 2 and 3-year survival rates of group A were 60.0%, 41.1%, 27.4%, respectively. The median survival time was 15 months. The 1,2 and 3-year survival rates of group B were 47.8%, 19.1%, 0%, respectively. The median survival time was 10 months. The effect diffrence between group A and B was significant (P=0.046). Subgroup analysis revealed that 1 , 2 and 3 years survival rate and median survival time of group A were significantly superior to group B, especially to those patients with 1-2 BMs, male or age <59 years old (P <0.05). MMSE scores at the end of radiation and at 1 month after radiation were not significantly different from those before treatment in both group (p> 0.05), however, the scores at 3 or 6 months after radiation were lower than before radiation, the difference was significant(p<0.05). There was no significant difference in MMSE scores in the 2 group before radiation, at the end of radiation, at 1 month after radiation and at 6 months after radiation (P> 0.05) .The scores of group A at 3 months after radiation was higher than that of group B (p <0.05). Certainly, group A had longer radiotherapy time and more cost than group B (p<0.005).

Conclusion: For finite number of BMs in non-small cell lung cancer, WBRT+SEB is likely to be better thanWBRT+SIB, especially to 1-2 metastases, male or aged <59 years patients. The decline of cognitive function in both groups occurred after 3 months of radiation, and WBRT+SEB group seems to be less impairment of brain cognitive function than that WBRT+SIB group. It is worth further study to verify Which boost scheme will be better.

Author Disclosure: D. Ma: None. D. Qing: None. H. Zhu: None.

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