CMET-40. IMPACT OF WHOLE BRAIN RADIOTHERAPY ON LEPTOMENINGEAL METASTASIS FROM NON-SMALL CELL LUNG CANCER

Abstract

Abstract BACKGROUND Leptomeningeal metastasis (LM) is a detrimental complication of patients with non-small cell lung cancer (NSCLC) and its incidence has increased due to recent improvements in survival. The aim of this study was to assess the impact of whole brain radiotherapy (WBRT), chemotherapy and epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) on survival. METHODS Seventy-four consecutive patients diagnosed with LM from NSCLC between 2009 and 2018 in Sanjiu Brain Hospital were retrospectively reviewed. Survival was assessed by Kaplan-Meier analyses. RESULTS The median age was 54.5 (range 30–76) years. LM were diagnosed by MRI (36/74), cytology (4/74), or both (34/74). Eighteen patients (24.3%) were diagnosed at the initial presentation of lung cancer. Forty-seven (63.5%) patients harboring EGFR positive mutation while other twenty-seven patients (36.5%) were EGFR wild type. The median overall survival from diagnosis of LM was 8.1 months (95% confidence interval: 5.2 to 11.0). Patients who received EGFR-TKIs after LM had longer survival than those who did not (10.5 vs. 4.4 months, p＜0.001). No significant differences in survival were seen between patients who were treated with WBRT and those without, whether in EGFR mutation positive patients (11.6 vs. 15.0 months, p=0.353), or in EGFR wild type ones (5.1 vs. 3.3 months, p=0.116). Similarly, intravenous chemotherapy after LM had no impact on overall survival (7.5 vs. 8.1 months, p=0.9). CONCLUSION Median overall survival was higher than historical experience in our retrospective analysis. Survival was not improved by WBRT or intravenous chemotherapy. EGFR-TKIs could prolong survival of patients with LM from NSCLC.