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P1.07-049 Limited Stage Small Cell Lung Cancer: Patterns of Care and Outcomes of a Single Institution over 15 Years
January 2017
OS of ED-SCLC patients treated with carboplatin plus etoposide. Keywords: overall survival, post-progression survival, Progression-free survival, extensive disease small cell lung cancer
P1.07-049 Limited Stage Small Cell Lung Cancer: Patterns of Care and Outcomes of a Single Institution over 15 Years Topic: SCLC/Neuroendocrine Tumors in General Eunji Hwang,1 Janet Williams,1 Rebecca Venchiarutti,1 Craig Lewis,2 Wenchang Wong1 1Radiation Oncology, Prince of Wales Hospital, Randwick/NSW/Australia, 2Medical Oncology, Prince of Wales Hospital, Randwick/NSW/Australia Background: The past two decades have seen an increase in survival of patients with limited stage small cell lung cancer (SCLC). This retrospective audit analyzed patterns of care, toxicity and survival for all patients with limited stage SCLC diagnosed and treated at Prince of Wales hospital over 15 years. Our results were compared with the literature to assess this single institution’s performance and outcomes, and explore what factors may most be influencing these results. Methods: We identified 120 patients diagnosed with SCLC at Prince of Wales Hospital between 2000 and 2014 from the departmental electronic patient information system (Mosaiq). Eligibility criteria were: age >18 years, histopathologically confirmed diagnosis of SCLC, limited stage according to the two-stage Veterans’ Affairs Lung Study Group staging criteria (2016), and treatment with either curative or palliative intent. Median progression free survival (PFS), cancer specific survival (CSS) and overall survival (OS) were estimated using the KaplanMeier method and log-rank test (IBM SPSS version 23.0). Results: Thirty-two patients fulfilled the eligibility criteria. The median age of patients was 66.5 years; 19 (59%) patients were female and 50% had an Eastern Cooperative Oncology Group (ECOG) score of 0. Median PFS, CSS and OS were 12.6, 22.1 and 18.0 months respectively, comparable with published literature. Ten patients (31%) received prophylactic cranial irradiation (PCI) as a component of their therapy. Of the 10 patients who received PCI, none had brain recurrence, while 36.4% of the non-PCI group developed brain metastases. Patients receiving PCI demonstrated a trend toward improved PFS compared to patients not receiving PCI (18.3 months versus 10.5 months, p¼0.057). This trend was also seen in OS in this group (25.4 months versus 15.5 months,
Abstracts
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p¼0.072). The median time from date of diagnosis to start of chemotherapy was 21 days, and there was correlation between time to chemotherapy and OS (p¼0.037) and PFS (p¼0.045). Twenty-six of the 32 patients underwent a combination of chemotherapy and radiotherapy. Seventeen patients (65%) received concurrent chemoradiotherapy, and 9 (35%) received sequential chemoradiotherapy, with no significant difference in survival or toxicity between these two regimens. Conclusion: Survival outcomes from this single institution are comparable with current literature. The use of PCI in appropriate patients can prevent cerebral metastases, improve PFS and ultimately OS. The time to initiation of chemotherapy may also have a significant impact on outcomes. Keywords: limited stage, small cell lung cancer, cancer treatment, Survival outcomes
P1.07-050 Patterns of Relapse in Small Cell Lung Cancer (SCLC): A Retrospective Analysis of Outcomes from a Single Canadian Center Topic: SCLC/Neuroendocrine Tumors in General Abdulaziz Al Farsi,1 Anand Swaminath,2 Peter Ellis2 1 Medical Oncology, Juravinski Cancer Center, Hamilton/ Canada, 2Oncology, McMaster University, Hamilton/ Canada Background: We conducted a retrospective review of small cell lung cancer patients (SCLC) to explore patterns of relapse and utility of Prophylactic Cranial Irradiation (PCI). Methods: A retrospective chart review was carried on patients diagnosed with SCLC from January 1st 2011 until December 31st 2014 and treated at Juravinski Cancer Center. The primary outcome was to determine pattern of first relapse. Secondary outcomes were physician assessed response rate, overall survival (OS), utilization of PCI, time to systemic relapse (TTR) and time to central nervous system (CNS) relapse. Results: A total of 275 patients were identified, of whom 46 (16.7%) received no chemotherapy (median OS 2.2 months (m)) and were not included in further analyses. The median age of 229 treated patients was 66 (SD 9.3) yrs. There were 115 men, 114 women, 84 (37%) had limited stage (LS) and 145 (63%) extensive stage (ES) disease, performance status (PS) was 0-1 in 133 (58%), PS2 in 66 (28%) and PS3-4 in 32 (13%). Brain metastases were present in 36 (16%) patients at diagnosis. Almost all patients received cisplatin (53%) or carboplatin (43%) plus etoposide chemotherapy. Most patients received 4
OS of ED-SCLC patients treated with carboplatin plus etoposide. Keywords: overall survival, post-progression survival, Progression-free survival, extensive disease small cell lung cancer
P1.07-049 Limited Stage Small Cell Lung Cancer: Patterns of Care and Outcomes of a Single Institution over 15 Years Topic: SCLC/Neuroendocrine Tumors in General Eunji Hwang,1 Janet Williams,1 Rebecca Venchiarutti,1 Craig Lewis,2 Wenchang Wong1 1Radiation Oncology, Prince of Wales Hospital, Randwick/NSW/Australia, 2Medical Oncology, Prince of Wales Hospital, Randwick/NSW/Australia Background: The past two decades have seen an increase in survival of patients with limited stage small cell lung cancer (SCLC). This retrospective audit analyzed patterns of care, toxicity and survival for all patients with limited stage SCLC diagnosed and treated at Prince of Wales hospital over 15 years. Our results were compared with the literature to assess this single institution’s performance and outcomes, and explore what factors may most be influencing these results. Methods: We identified 120 patients diagnosed with SCLC at Prince of Wales Hospital between 2000 and 2014 from the departmental electronic patient information system (Mosaiq). Eligibility criteria were: age >18 years, histopathologically confirmed diagnosis of SCLC, limited stage according to the two-stage Veterans’ Affairs Lung Study Group staging criteria (2016), and treatment with either curative or palliative intent. Median progression free survival (PFS), cancer specific survival (CSS) and overall survival (OS) were estimated using the KaplanMeier method and log-rank test (IBM SPSS version 23.0). Results: Thirty-two patients fulfilled the eligibility criteria. The median age of patients was 66.5 years; 19 (59%) patients were female and 50% had an Eastern Cooperative Oncology Group (ECOG) score of 0. Median PFS, CSS and OS were 12.6, 22.1 and 18.0 months respectively, comparable with published literature. Ten patients (31%) received prophylactic cranial irradiation (PCI) as a component of their therapy. Of the 10 patients who received PCI, none had brain recurrence, while 36.4% of the non-PCI group developed brain metastases. Patients receiving PCI demonstrated a trend toward improved PFS compared to patients not receiving PCI (18.3 months versus 10.5 months, p¼0.057). This trend was also seen in OS in this group (25.4 months versus 15.5 months,
Abstracts
S727
p¼0.072). The median time from date of diagnosis to start of chemotherapy was 21 days, and there was correlation between time to chemotherapy and OS (p¼0.037) and PFS (p¼0.045). Twenty-six of the 32 patients underwent a combination of chemotherapy and radiotherapy. Seventeen patients (65%) received concurrent chemoradiotherapy, and 9 (35%) received sequential chemoradiotherapy, with no significant difference in survival or toxicity between these two regimens. Conclusion: Survival outcomes from this single institution are comparable with current literature. The use of PCI in appropriate patients can prevent cerebral metastases, improve PFS and ultimately OS. The time to initiation of chemotherapy may also have a significant impact on outcomes. Keywords: limited stage, small cell lung cancer, cancer treatment, Survival outcomes
P1.07-050 Patterns of Relapse in Small Cell Lung Cancer (SCLC): A Retrospective Analysis of Outcomes from a Single Canadian Center Topic: SCLC/Neuroendocrine Tumors in General Abdulaziz Al Farsi,1 Anand Swaminath,2 Peter Ellis2 1 Medical Oncology, Juravinski Cancer Center, Hamilton/ Canada, 2Oncology, McMaster University, Hamilton/ Canada Background: We conducted a retrospective review of small cell lung cancer patients (SCLC) to explore patterns of relapse and utility of Prophylactic Cranial Irradiation (PCI). Methods: A retrospective chart review was carried on patients diagnosed with SCLC from January 1st 2011 until December 31st 2014 and treated at Juravinski Cancer Center. The primary outcome was to determine pattern of first relapse. Secondary outcomes were physician assessed response rate, overall survival (OS), utilization of PCI, time to systemic relapse (TTR) and time to central nervous system (CNS) relapse. Results: A total of 275 patients were identified, of whom 46 (16.7%) received no chemotherapy (median OS 2.2 months (m)) and were not included in further analyses. The median age of 229 treated patients was 66 (SD 9.3) yrs. There were 115 men, 114 women, 84 (37%) had limited stage (LS) and 145 (63%) extensive stage (ES) disease, performance status (PS) was 0-1 in 133 (58%), PS2 in 66 (28%) and PS3-4 in 32 (13%). Brain metastases were present in 36 (16%) patients at diagnosis. Almost all patients received cisplatin (53%) or carboplatin (43%) plus etoposide chemotherapy. Most patients received 4