Carsten Nieder1,2, Siv G Aanes3, Ellinor Haukland3,4,5. 1. Department of Oncology and Palliative Medicine, Nordland Hospital, 8092, Bodø, Norway. carsten.nieder@nlsh.no. 2. Department of Clinical Medicine, Faculty of Health Sciences, UiT-The Arctic University of Norway, 9037, Tromsø, Norway. carsten.nieder@nlsh.no. 3. Department of Oncology and Palliative Medicine, Nordland Hospital, 8092, Bodø, Norway. 4. Department of Clinical Medicine, Faculty of Health Sciences, UiT-The Arctic University of Norway, 9037, Tromsø, Norway. 5. SHARE-Center for Resilience in Healthcare, Faculty of Health Sciences, Department of Quality and Health Technology, University of Stavanger, 4036, Stavanger, Norway.
Abstract
PURPOSE: The purpose of this study was to evaluate overall survival after systemic therapy, largely chemotherapy, in patients with small cell or non-small cell lung cancer and brain metastases. After completion of systemic therapy, some patients received planned brain irradiation, while others were followed. METHODS: Retrospective cohort study. RESULTS: Thirty-eight patients were included (28 small cell, 20 followed with imaging). Six of these 20 patients (30%) received delayed radiotherapy during follow-up. Planned radiotherapy (n = 18, intention-to-treat) was associated with longer survival from diagnosis of brain metastases, median 10.8 versus 6.1 months, p = 0.025. Delayed radiotherapy still resulted in numerically better survival than no radiotherapy at all (median 8.8 versus 5.3 months, not significant). If calculated from the start of delayed radiotherapy, median survival was only 2.7 months. In a multivariable analysis, both Karnofsky performance status ≥ 70 (p = 0.03) and planned radiotherapy (p = 0.05) were associated with better survival. CONCLUSION: In patients ineligible for targeted agents, planned radiotherapy in a modern treatment setting was associated with longer survival compared to no radiotherapy. Timing and type of radiotherapy in such patients should be evaluated in prospective trials to identify patients who might not need planned radiotherapy.
PURPOSE: The purpose of this study was to evaluate overall survival after systemic therapy, largely chemotherapy, in patients with small cell or non-small cell lung cancer and brain metastases. After completion of systemic therapy, some patients received planned brain irradiation, while others were followed. METHODS: Retrospective cohort study. RESULTS: Thirty-eight patients were included (28 small cell, 20 followed with imaging). Six of these 20 patients (30%) received delayed radiotherapy during follow-up. Planned radiotherapy (n = 18, intention-to-treat) was associated with longer survival from diagnosis of brain metastases, median 10.8 versus 6.1 months, p = 0.025. Delayed radiotherapy still resulted in numerically better survival than no radiotherapy at all (median 8.8 versus 5.3 months, not significant). If calculated from the start of delayed radiotherapy, median survival was only 2.7 months. In a multivariable analysis, both Karnofsky performance status ≥ 70 (p = 0.03) and planned radiotherapy (p = 0.05) were associated with better survival. CONCLUSION: In patients ineligible for targeted agents, planned radiotherapy in a modern treatment setting was associated with longer survival compared to no radiotherapy. Timing and type of radiotherapy in such patients should be evaluated in prospective trials to identify patients who might not need planned radiotherapy.
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