P-769 Prognostic relevance of 56 clinical factors, “classical” laboratoryparameters and tumor markers in patients with small cell lung cancer

Posters/Small cell lung cancer choice. All patients v~th good PR or CR recedved PCI (30Gy in 15 fractions) at the end of tTeatmont Toxicity. local contTol, relapse pattern and survival data wore collected Possible prognostic factors as age. ses. lung function. kamofsky, treated volume, dose level and PCI or not were tested ~ r survival Results: 62 consecutive palJents were tTeated between Jan-g8 and Dec-03. 25 men and 37 women, median age 65 (range 4,5 77) 37 patients (60%) received 60Gy and 2,5 patients (40%) 45Gy The groups were dif~ront due to median lung function (FEVl 2 0 vs 1 6) and median treated volume (69,5 vs 622 crn3). Radiation induced toxicity: Esophagltis grade III (RTOG/EORTC) 19%. pneumonltis any grade 10% and no clfferenca between the groups. The total 3 and ~year overall su~val was 33% and 20%. respectively with a median survrval of 20.1 months v~th no significant difference between the groups. However. local oDnt]-ol was improved in the 60 Gy group (93% vs 60%). None of the tested proposed prognostic factors came out signlhcantly escept whether PCI was given or not. However. the reason for this is obvious while not giving PCI was due to patient datorialJon Caosa of death was cistant metastases in 66% (including 40% brain metastases). Ioco regional progression in 9% and intarourrent disease in 11% Patients who received PCI developed brain metastases in 21% compared to 63% in the non PCI group Conduslon: Thoracic radiotherapy to 60Gy with accelerated fractionation is feasible with acceptable toxicity and showed improved local control compared to 4,sGy BID However. this did not tTanslate into increased survival Whether tits is due to small sample size. or impact of distant metastases development. which is the most common cause of death, is not clear.

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Phase II study of Idnotecarttclsplatln Induction followed by concurrent twice-dally t h o r a d c Irradiation w l ~ etoposlds/.clsplatln chemo~erapy for IlmltKI ¢lsease small cell lung cancer

J. Hen. K. Cho. D. Lee. H. Kim. E. Kim. S. Lee. J. Lee. National Cancer

Center, Goyang, South Korea Background: Idnotecen/.clsplatin (IP) chemotherapy demonstTated a promising outcome with high complete response (CR) rate in chemo-nalve patients with extensive small cell lung cancer (SCLC). We evaluated the efficacy of induction IP chemotherapy followed by concurrent etopeside/c~splatin ([_P) chemotherapy with twlce
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Prognostic relevance of 56 dlnlcel factors, "dasslcal" laboratory parameters and tumor markers In patients with small cell lung cancer

S. Hcldenrleder ~. J. yon Pawel ~. H. Ralth ~. K. Feldmano ~. U. Stenman 3. D. Nagel ~. P. Stiebor ~. ~Un/vers~ty Hospital. Muntch~rosshadem, Mum#n,

Germany. ~As/~eptos Hospital, Gaut]ng, Germany;, 3He/'smk~ Untverstty Central Hosptta/, Hefs~nkt Fm/'an¢ Background: Currently available data concerning the prognostic relevance of biochemical markers in small cell lung cancer are conflic~ng Msthods: In a prospective study on 121 pal~ents with newly diagnosed small cell lung cancer undergoing chemotharapy, wa investigetad 56 pretherapautic parameters including clinical factors (age. gender, performance score (PS). weight loss (WL). stage, number and sites of metastases, mode of therapy). "dessical" laboratory markers (WBC. RBC. hemoglobin, platelets. CRY. socium, potassium, cNoride, calcium, creatinina, urea. glucosa, uric acid. tngiycende, cholesterol, albumin, bilirubln. AST. ALT. GGT. A,R. LDH). and tumor markers (CEA. CYFRA 21-1. NSE. CA125. CA15-3. CA72-4. CA19- 9. $100 all by Eleosys/Roche; SCC by ImX/Abbott; ProGRP by ELISA/ALSI IBL. Chromogranln A by RINScberlng. hCGI3 and TATI by IFMA. nucleosomes by ELISAfRoche. and caspeses by IFMA/Rocbe).

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Clinical parameters with independent prognostic relevance wore selected by Cox regression analysis Second. all log transformed values of biochemical markers wore included separately in Cox regression analyses with these clinical factors selected in step one All markers which remained in the models with a p-value <0 1 were analysed subsequently by Cox regression using both forward and backward selection in parallel In this final model a p-value <0 05 was considered statislJcally significant Results: Median observation time of all 121 patients was 6 6 months (range 1 to 30). 42 of these patients have clad dunng the investigation time. Of the clinical factors. PS and WL showed prognostic relevance, whereas stage was only of borderline sigrlfK:anca in the multrvarlate analys~s. In the subsequent Cox regression analyses including separately the log transformed values of all biochemical markers with PS and WL. 11 were retained including LDH. albumin. NSE. CYFRA 21-1. Chromogranin A. TATI. calcium, urea. AS].. GGT. and thrembocytes. When these markers were included in both forward and backward sele~on, the resulting multivariate model compnsed PS. WL. Inalbumin, and In~DH with hazard ratios of 3 1.2 6. 0 004. and 2 5. respectively Conclusion: In a standardized prrecedure ~r establisitng prognosis in small call lung cancer PS. WL. albumin and LDH were found to be independent prognoslJc markers

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Topotscan Improves performance status (PS) and ctlnlcel response In paUents with relapsed small cell lung cancer (SCLC) and poor PS at baseline

R. Huber I . R. Lilenbaum 2. J. Treat 3. G. Masters 4. S. Kaubltzsch ~. S. Lane6.

l Kl/n/kum Der Un/versttaet lnnenstaCt, MLnlIch, Germany, 2 The Mount S/hal Comprehensive Cancer Center, Miami Beach, FL, USA, ~Fox Chase-Temple Cancer Center, Philadelphia, PA, USA, SHe/an E Graham Cancer Center, Newark, DE, USA, 5GlaxoSmithKfins, Munich, Germany,, ~GlaxoSmitht~ine, Coilegetelle, PA, USA Background: SCLC is an aggressive malignancy After response to first4ine chemotherapy, most patients will relapse and e~(porience a progressive decline in performance status Recently. topotecan was reported to be generally well tolerated and ac~ve in patients with poor PS (PS 2)(Treat et al Oncotogist 2904:g:173 18.1) In this analysis, we investigated the potential benefit of single agent topotecan on PS outcomes and clinical response in patients with relapsed SCLC who had poor PS at treatment initiation. Methods: We performed a ret]'ospectlve analysis of data from 7 clinical b-lals ON= 795) in which patients with relapsed SCLC and PS 0. 1. or 2 were t]'eated with topotecan at doses ranging from 1 0 mg/m2/day to 1 5 mg/m2/day days 1 through 5 of a 21 2 was 1.5 (range. 1 to 14). Dose delays occurred in 34.4% of the PS 0/1 group and 36.1% of the PS 2 groqo and dose reductions in 11.3% of the PS 0/1 patients and 14.9% of the PS 2 patients. Of the 153 patients with PS 2 at baseline. 32 (21%) espenenced improvement in PS (to PS 0/1) during t]'eatment with topotecan that persisted for at least 2 courses. Overall antltumor response (complete response [CR]+partial response [PR]) to topotecan was b0% in patients who expananesd persistent PS conversion compared with 7 6% in patients who had no improvement Similarly. 28. 1% of patients with persistent improvement had stable disease (SD). compared with 14 3% of those with PS 2 at baseline who did not improve Overall response in palJents with PS 0/1 was 15 g%: an adcilJonal 24% had SD In patients with persistent PS improvement, macian overall survival was 37 weeks (gb%CI: 29.6. 49.4 weeks), compared v~th 10.4 weeks (95%C1: 8.7. 13.6 weeks) for those with PS 2 with no improvement. Survival in patients with improved PS appeared to be sNoenor to patients with PS 0/'1 at baseline (29.9 weeks; 95%C1: 27.6. 31.9 weeks). Hematologic and nonhematclogic toxicity was consistent with the Imown probe of topotecan. Conclusions: In this analys~s. 21% of patients presenting with PS 2 at baseline reported a sustained improvement in their PS during treatment. ~ t h half achieving either a CR or PR SCLC patients with PS 2 at relapse can derive dinically meaningful benefit from treatment with IV topotecan

P~P--~I] Surgical trestment of small cell lung cancer during 1980 2003 years A. Jackavic~us. S. Cicenes. E. Aleknavic~us. A. Cicaniene. lnsbtute o~

Oncotogy, V#n/us Un/versrty, V#n/us, Ltthuanta Background: To analyze the results of tTeatment of small cell lung cancer (SCLC) during period 1980 2903 years There are studies, in which authors declared that patients (pts) with SCLC could net be treated surgically On the other hand other authors reported a survival rate of 33% of five years in the the first stage of the disease In tits paper we want to show hew the surgical treatment for SCLC can improve the follow~Jp results. Methods: In Clinic of Institute of Onoology VInius Unlvers~ 2130 pts with lung cancer wore treated surgically in the course of 1980 till 2003 years. In 215 cases small cell lung cancer was diagnosed. The dis~bution ofpts accerding to