P2.03b-007 Palliative Whole Brain Radiotherapy in Advanced Non-Small Cell Lung Cancer (NSCLC), the University College London Hospital Experience: Topic: Brain Meta

Abstract

Brain metastases occur in 30-40% of patients with Non-Small Cell Lung Cancer (NSCLC).1 Whole Brain Radiotherapy (WBRT) has been standard treatment in those with multiple metastases although this has been challenged by the Quartz trial. This suggested there was no advantage over supportive care in terms of survival (median 66 days in the RT arm) or quality of life.1,2 In our center Quartz has divided opinions and practice. We thus decided to review our data of 163 patients who were treated with WBRT in the context of advanced NSCLC. Radiotherapy database information was used to identify patients receiving WBRT for metastatic NSCLC between 2007 and 2015. Patients with completely resected brain metastasis were excluded. Notes were reviewed retrospectively. Data were collected on demographics, performance status (PS), histology, disease status, further treatment following WBRT and survival. 163 patients were identified of which 153 had complete follow up data to review. The demographics are presented in the table below. The median survival across all patients was 104 days. Longer survival was seen in those with PS0/1 (median=225 days) vs. PS3 (median =44 days) Of the 19 patients surviving longer than 1 year, 95% were PS 1 and all went on to receive further treatment for NSCLC upon completion of WBRT. Conversely 26 patients had a survival of less than 30 days. 70% were PS2 or 3. None of them received further treatment following WBRT.Tabled 1N=163Number%Median Survival (days)Female7244%Male9156%Median Age65HISTOLOGYAdenocarcinoma EGFR WT10464%Adenocarcinoma EGFR Mutant106%Adenocarcinoma ALK rearrangement1<1%Squamous cell Carcinoma2012%Other Inc. NSCLC NOS2817%PERFORMANCE STATUSPS0/17244%225PS25634%80PS32817%44DISEASE STATUSBrain metastasis as 1st presentation of NSCLC7747%146Brain metastasis in known NSCLC8653%85Extracranial metastasis12578%89No Extracranial metastasis3522%160Further treatment following WBRT5534%313OVERALL SURVIVAL104 days Open table in a new tab In our series survival was seen to be favorable when compared to the radiotherapy arm of Quartz. Performance status and the option for further treatment seemed to improve outcome. Whilst lacking QOL data and a supportive care control group, our data would suggest that for selected patients, especially those of good PS there remains a role for WBRT in NSCLC.