Ryoko Suzuki1, Xiong Wei2, Pamela K Allen2, James W Welsh2, Ritsuko Komaki2, Steven H Lin3. 1. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA. Electronic address: szk.mrad@tmd.ac.jp. 2. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA. 3. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA. Electronic address: SHLin@mdanderson.org.
Abstract
BACKGROUND AND PURPOSE: We sought factors associated with the development of brain metastases after treatment of small cell lung cancer (SCLC) in patients without brain involvement at diagnosis. METHODS: We analyzed 293 patients with SCLC without brain metastases who received chemotherapy, thoracic radiation therapy (TRT), or both in 2001-2015. Pretreatment hematologic markers (platelet count, neutrophil count, lymphocyte count, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and lactate dehydrogenase) and other clinical characteristics were evaluated for correlation with brain metastases-free survival (BMFS). Cutoffs were established with receiver operating characteristics curves. Factors significant in univariate analysis were used to build a multivariate Cox model for BMFS. RESULTS: Median follow-up time was 14.3 months. Brain metastases developed in 115 patients (39%)-32% of those with low pretreatment platelet counts (PPC) (≤270 × 109/L) and 46% of those with high PPC (>270 × 109/L). Median BMFS time for all patients was 27.9 months. Two-year BMFS rates were worse for patients with high PPC (14.6% vs. 22.1% low, P = 0.009). High PPC was independently associated with inferior BMFS (P = 0.038), as were receipt of TRT <45 Gy and no prophylactic cranial irradiation (both P < 0.001). CONCLUSIONS: High PPC was associated with increased rates of brain metastasis in patients with SCLC with no evidence of brain disease at diagnosis.
BACKGROUND AND PURPOSE: We sought factors associated with the development of brain metastases after treatment of small cell lung cancer (SCLC) in patients without brain involvement at diagnosis. METHODS: We analyzed 293 patients with SCLC without brain metastases who received chemotherapy, thoracic radiation therapy (TRT), or both in 2001-2015. Pretreatment hematologic markers (platelet count, neutrophil count, lymphocyte count, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and lactate dehydrogenase) and other clinical characteristics were evaluated for correlation with brain metastases-free survival (BMFS). Cutoffs were established with receiver operating characteristics curves. Factors significant in univariate analysis were used to build a multivariate Cox model for BMFS. RESULTS: Median follow-up time was 14.3 months. Brain metastases developed in 115 patients (39%)-32% of those with low pretreatment platelet counts (PPC) (≤270 × 109/L) and 46% of those with high PPC (>270 × 109/L). Median BMFS time for all patients was 27.9 months. Two-year BMFS rates were worse for patients with high PPC (14.6% vs. 22.1% low, P = 0.009). High PPC was independently associated with inferior BMFS (P = 0.038), as were receipt of TRT <45 Gy and no prophylactic cranial irradiation (both P < 0.001). CONCLUSIONS: High PPC was associated with increased rates of brain metastasis in patients with SCLC with no evidence of brain disease at diagnosis.
Authors: Haiyan Zeng; Danyang Zheng; Willem J A Witlox; Antonin Levy; Alberto Traverso; Feng-Ming Spring Kong; Ruud Houben; Dirk K M De Ruysscher; Lizza E L Hendriks Journal: Front Oncol Date: 2022-06-10 Impact factor: 5.738