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Extracranial Metastatic Burden In Extensive-stage Small Cell Lung Cancer

Title: Extracranial Metastatic Burden In Extensive-stage Small Cell Lung Cancer: Implications For Prophylactic Cranial Irradiation.
Name(s): Oliver, Daniel E., author
Donnelly, Olivia G., author
Grass, G. Daniel, author
Naghavi, Arash O., author
Yang, George Q., author
Dilling, Thomas J., author
Perez, Bradford A., author
Type of Resource: text
Genre: Journal Article
Journal Article
Date Issued: 2018-07-01
Physical Form: computer
online resource
Extent: 1 online resource
Language(s): English
Abstract/Description: Background: Patients with extensive-stage small cell lung cancer (ES-SCLC) often develop brain metastases. There is significant controversy regarding the benefit of prophylactic cranial irradiation (PCI) for patients with ES-SCLC. Our objective is to identify ES-SCLC patients who might be most likely to benefit from PCI. Methods: We retrospectively reviewed 173 patients with ES-SCLC treated between 2010-2015. Of these, 117 patients were initially diagnosed without brain metastases and received systemic chemotherapy. Following exclusion of patients who received PCI and less than 2 cycles of platinum doublet therapy, 93 patients remained. Patient records were reviewed for clinical and radiographic features previously identified as relevant risk factors. Primary outcome was brain metastasis-free survival (BMFS). Kaplan-Meier analysis, log-rank tests and Cox multivariate models were used to compare outcomes. Results: Median follow-up was 10.7 months (range, 3-58 months). Thirty-eight (40.9%) patients developed brain metastases. Three or more metastatic sites was associated with inferior BMFS on univariable (1-year estimate 43.8% vs. 61.3%; P=0.020) and multivariable (MVA) analysis (hazard ratio (HR) 2.33, 95% CI: 1.08-5.01; P=0.03). Conclusions: Our results suggest that extracranial metastatic burden is associated with an increased risk for brain metastases in patients with ES-SCLC. As there is no clear standard regarding delivery of PCI in this patient population, utilizing the number of metastatic disease sites as a clinical indicator may help to improve selection of patients who benefit from PCI.
Identifier: FSU_libsubv1_wos_000440380200071 (IID), 10.21037/jtd.2018.06.92 (DOI)
Keywords: controlled-trial, extensive-stage small cell lung cancer (ES-SCLC), prophylactic cranial irradiation (PCI), Radiotherapy
Publication Note: The publisher’s version of record is available at
Persistent Link to This Record:
Owner Institution: FSU
Is Part Of: Journal of Thoracic Disease.
Issue: iss. 7, vol. 10

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Oliver, D. E., Donnelly, O. G., Grass, G. D., Naghavi, A. O., Yang, G. Q., Dilling, T. J., & Perez, B. A. (2018). Extracranial Metastatic Burden In Extensive-stage Small Cell Lung Cancer: Implications For Prophylactic Cranial Irradiation. Journal Of Thoracic Disease. Retrieved from