P2.10-005 Overall Survival of Lung Cancer Patients with Brain Metastases in a Developing Country

November 2017 treatment aim. Better treatment aims could be provided, if the level of decline in physical functioning was objectively collected and evaluated. To our knowledge, the significance of functional capacity in patients with lung cancer has never been evaluated prior to this review. Thus, the aim of this study was to identify and evaluate the evidence objectively examining 1) the decline in functional capacity in patients with lung cancer during cancer treatment, and 2) the prognostic value of functional capacity for patients with lung cancer. Method: The systematic review was reported according to PRISMA guidelines. A search in three databases: PubMed, EMBASE and Web of Science, generated 171 articles. Quantitative study designs, including case-series and casecontrols, assessing functional capacity in patients with lung cancer were included. Self-reported functional capacity was excluded. No restrictions on publication date were imposed. Only articles published in English were considered for inclusion. Result: Eight studies on a total of 908 patients with lung cancer met the inclusion criteria. The majority of the studies were prospective cross-sectional studies (n¼7), remaining was a case-control (n¼1). Patients with lung cancer had already declined in functional capacity at baseline compared to healthy adults, and deteriorated further during initial cancer treatment. Functional capacity as a predictive measure was not associated with radiation induced lung injury. A 6-minute walking distance (6MWD) >400 m was associated with a 56% reduction in the risk of death, and every 50 m improvement in 6MWD was associated with a 13% risk reduction. Conclusion: The results of this review demonstrate that functional capacity (6MWD) declines following non-surgical NSCLC treatment as well as low functional capacity being associated with higher risk of mortality. By implementing an objective measure for functional capacity at the time of diagnosis, it could be possible to generate targeted treatment aims throughout the medical treatment and rehabilitation process. In addition, an objective measure for functional capacity could provide a better prognostic stratification. Keywords: performance status, functional capacity, Prognosis

P2.10-004 Efficacy and Safety of Viscum Album (Helixor M) to Treat Malignant Pleural Effusion in Patients with Advanced Lung Cancer Y. Lee, I. Jung, S. Lee Internal Medicine, Kangbuk Samsung Hospital, Seoul/KR Background: Lung cancer, the most common metastatic tumor to the pleura, accounts for approximately 40% of all malignant pleural effusion (MPE). Regarding symptomatic MPE, local therapies including pleurodesis and treatment of primary malignancy are required to alleviate dyspnea and/or pleuritic pain. Helixor-M made from European mistletoe (Viscum album) has been used as adjuvant anticancer treatment by boosting immune system. We have used Helixor-M as sclerosing agent for pleurodesis to control MPE. The aim of this study is to evaluate efficacy and safety of Helixor-M to control MPE. Method: Between 2009 and 2015, we consecutively enrolled 52 patients with lung cancer who were treated with Helixor-M for MPE and analyzed retrospectively. For pleurodesis, we instilled 100mg of Helixor-M via pleural catheter at Day 1. After 3-hours of frequent repositioning we drained residual pleural fluid. If prior procedures were not effective, we repeated this procedure up to 5 times every second day with increasing dose by 100mg. Our primary study outcome was reappearance of pleural effusion 1-month after pleurodesis. Result: The median age was 63 years and 77% were male. Among 52 patients, 69% were adenocarcinoma, followed by squamous cell (13%), not otherwise specified (10%), and small cell lung cancer (8%). About 85% of MPE were cytogenetically malignant. Among 52 patients, 39 (75%) were evaluable for recurrence of MPE. The 1-month recurrence rate was 49% (19/39). Among 19 patients who experienced recurrent MPE, 6

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required recurrent pleural drainage. One fourth of patients experienced significant pain after pleurodesis. Only 15% of patients experienced fever. Conclusion: Our results suggest that a pleurodesis with HelixorM was effective and tolerable procedure to control MPE in advanced lung cancer patients. Keywords: malignant pleural effusion, pleurodesis, helixor M

P2.10-005 Overall Survival of Lung Cancer Patients with Brain Metastases in a Developing Country T. Kovacevic,1 B. Zaric,1 D. Bokan2 1Clinic for Thoracic Oncology, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Sremska Kamenica/RS, 2Clinical Trials Unit, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, University of Novi Sad, Sremska Kamenica/RS Background: Brain metastases (BM) are common in due course of lung cancer (LC). The clinical presentation of BM can be very distressing for family/caregivers and urges for immediate treatment. Despite the early diagnosis and multimodality treatment of BM, prognosis remains poor. Considering the fact that treatment options in developing countries are limited (WBRT, surgery and SBRT) individual approach and specific prognostic assessment is highly important for further disease management. Aim of this study was to gather information and make approximation of overall survival (OS) of LC patients with BM. Method: This observational trial was conducted at the Institute for Pulmonary Diseases of Vojvodina, Serbia in the period from March 2010 to April 2015 taking into account all newly diagnosed LC patients. All data were harvested from the hospital based data capture system. The survival estimations were calculated regardless of the therapeutic interventions applied. Median OS was determined via Kaplan-Meier curves for all subgroups of LC patients with BM. Result: BM were diagnosed in 336 (5.1%) out of 6.624 LC patients in this 5 year period. Out of them, 182 patients were eligible for evaluation in this trial, the rest were excluded due to missing data. Majority of patients were male 68.1% (124), older than 60 years 50.0% (91), smokers 73.6% (134) with ECOG PS 1 76.4% (139). Most frequent LC type was adenocarcinoma 59.3% (108) followed by small-cell, squamous cell, and other types; 19.2% (35), 13.2% (24) and 8.2% respectively (13). One BM was present in 63.0% (63), 23 BM in 52.0% (52) and more than 3 in 34.6% (63) of patients. Extra cranial metastases (ECM) were present in 60.4% (110) of patients Median OS of all patients with BM regardless the histology was 8.5 (95%CI: 7.8-12.2) months. Median OS of patients with NSCLC, SCLC and other tumor types was 8.5 months (95%CI: 6.0-10.9), 10.0 months (95%CI: 7.8-12.2), and 5.5 months (95%CI: 0.1-11.0) respectively. Lowest median survival period was observed in patients with ECOG PS >3; 3.60 (95%CI: 0.2-7.0) months. Conclusion: The survival results of this trial show consistency with historical survival times. These results may suggest that survival outcomes for LC patients with BM are independent of applied therapy. Approximate survival prognosis taking into consideration individual (age and ECOG) and objective (tumor type, number of BM and presence of ECM) patient characteristics is highly important for further disease management in order to decrease patients burden and increase cooperation with family/caregivers. Keywords: palliative medicine, brain metastases, lung cancer

P2.10-006 Prognostic Factors of Mortality and Recurrence of Malignant Pleural Effusion in High-Risk Tumors According to the LENT Score Study F. Abrão,1 M. Oliveira,2 G. Viana,2 I. Abreu,2 R. Younes,2 C. Marciano1 1Thoracic Surgery, Hospital Santa Marcelina, São Paulo/ BR, 2Hospital Santa Marcelina, São Paulo/BR