P1-126 - Investigation between OS and clinical and laboratory findings at the time of administering chemotherapy in ED-SCLC

Abstract

Introduction: Survival of extensive disease small-cell lung cancer (ED-SCLC) is generally poor.Some clinical trials performed in several countries showed that overall survival (OS) of ED-SCLC was from about nine to twelve months.The relation between some clinical nor laboratory findings at starting chemotherapy and OS has not been proved yet. Aims and Methods: We intended to reveal whether the clinical or laboratory findings at the time of starting systemic chemotherapy would affect OS of ED-SCLC.We retrospectively checked medical records of 96 ED-SCLC patients, who received systemic chemotherapy in our institution from January 2007 to December 2015. Background: We classified the clinical and laboratory findings of the ED-SCLC patients before administrating systemic chemotherapy as follows:ages less than 70 years or over, sex, good PS (0-1) or poor PS (2-4), elevation of tumor markers (Pro-GRP and NSE) and LDH above their standard values, presence of pleural effusion, distant metastasis in brain, liver or bone. Result: Median OS from the first day of chemotherapy, analyzed at January 2016, was 259 days (95% confidence interval 222-313).The univariate analysis by logrank-test showed that statistical difference in shorter OS was observed in elder ages, poor PS, existence of bone or liver metastasis, and elevation of LDH. In a multivariate analysis these five selected variables, the factors significantly associated with shorter OS were poor PS (p<0.0001, HR3.81,95% C.I. 2.12-6.85), existence of bone metastasis (p<0.05, HR1.71, 95% C.I. 1.10-2.66) and liver metastasis (p<0.005, HR2.22, 95% C.I. 1.35-3.64). Conclusion: Poor PS, bone and liver metastasis were demonstrated to be the independent poor prognostic factors.We also concluded that brain metastasis did not play as a poor prognostic factor because most cases with brain metastasis received whole brain radiation therapy, and some cases with bone metastasis might improve their survival by receiving palliative radiation therapy.