P52.12 Incidence of Brain Metastasis in Advanced Non-Small Cell Lung Cancer at Presentation-An Experience From Tertiary Care Centre in South India

Abstract

Brain metastasis is one of the most significant problems in patients with lung cancer. Many patients with brain metastasis are asymptomatic at presentation.Due to its prognostic significance and bad survival, many studies looked upon the incidence of brain metastasis at the presentation of NSCLC. Most of them are retrospective studies conductedin different parts of the world. To the best of our knowledge, the frequency of brain metastasis in patients with NSCLC at initial presentation in India has not been studied.So we planned a study to evaluate the incidence of brain metastasis in NSCLC patients treated in our center. It is a prospective observational study conducted in the department of medical oncology at our tertiary care center from Sep 2019- March 2020. A total of 80 patients with lung cancer were registered in the department. Among them,66 patients had advanced non- small cell carcinoma of the lung (NSCLC),and they were enrolled in the study.Clinical profile,performance status, demographic characteristics, smoking history, and imaging findings were noted at the time of presentation. MRI brain was taken for all advanced NSCLC patients,and the results were analyzed. . Mean age at presentation was 60 years. 20(30%) patients were smokers and 46(70%) were non-smokersAmong 66 patients, 33% had brain metastasis. 15 (63%) patients were adenocarcinoma, whereas 9 (27%) patients had squamous cell carcinoma. 42% had asymptomatic brain metastasis at presentation. All patients with brain metastasis received radiotherapy. Other parameters are tabulated as follows.Tabled 1Baseline CharacteristicsParametersNo of Patients (%)Mean Age60 yearsMale36 (54%)Female30 (46%)ECOG0-256 (85%)310 (15%)Brain Metastasis24 (33%)Male10 (42%)Female14 (58%)Adenocarcinoma15 (63%)Squamous Cell Carcinoma9 (37%)Asymptomatic14 (58%)Symptomatic10 (42%)Hemorrhagic5 (21%)Non-hemorrhagic19 (79%)Synchronous metastasis12 (18%)Contralateral Lung Metastasis6 (9%)Liver4 (6%)Bone2 (3%) Open table in a new tab Our study has found that incidence of brain metastasis is higher in South India when compared to western data. The other findings include female patients had slightly higher predilection for brain metastasis. Adenocarcinoma histology and synchronous contralateral lung metastasis are common in patients with brain metastasis. There are no validated biomarkers to predict brain metastasis in NSCLC due to its molecular heterogeneity. As the study was conducted in resources limited setting molecular correlation in patients with brain metastasis was not done. The study will serve as a baseline platform of clinical predictors of brain metastasis in NSCLC. Our future direction and research will be clinical predictors along with molecular driver mutations in NSCLC in detecting brain metastasis