Journal Thoracic Oncology

Abstracts Journal of Thoracic Oncology • Volume 12 Issue S1 January 2017
for patients from the top accruing centers from the CREST trial. An evaluation
of 260 patients showed significantly better outcome in patients with 0 to
2 metastases versus and without liver metastases [10]. These patients are
believed to be best candidates for future studies.References:
1. Fried DB, Morris DE, Poole C, et al. Systematic review evaluating the timing
of thoracic radiation therapy in combined modality therapy for limited-stage
small-cell lung cancer. J Clin Oncol 2004. 22, 4837-45.
2. Turrisi AT 3rd, Kim K, Blum R, et al. Twice-daily compared with once-daily
thoracic radiotherapy in limited small-cell lung cancer treated concurrently
with cisplatin and etoposide. N Engl J Med. 1999 340, 265-71.
3. Faivre-Finn C, Snee M, Ashcroft L. CONVERT: An international randomised
trial of concurrent chemo-radiotherapy (cCTRT) comparing twice-daily (BD)
and once-daily (OD) radiotherapy schedules in patients with limited stage
small cell lung cancer (LS-SCLC) and good performance status (PS). ASCO
Meeting abstracts J Clin Oncol 2016, 8504.
4. Slotman BJ, Senan S; Radiotherapy in small-cell lung cancer: Lessons learned
and future directions. Int J Radiat Oncol Biol Phys 2011, 79, 998-1003.
5. Slotman BJ, Faivre-Finn C, Kramer G. Prophylactic cranial irradiation in
extensive small-cell lung cancer. N Engl J Med 2007, 357, 664-72.
6. Jeremic B, Shibamoto Y, Nikolic N, et al. Role of radiation therapy in the
combined- modality treatment of patients with extensive disease small-cell
lung cancer; A randomized study. J Clin Oncol 1999,17, 2092-9.
7. Slotman BJ, van Tinteren H, Praag JO, et al., Use of thoracic radiotherapy for
extensive stage small-cell lung cancer: a phase 3 randomised controlled trial.
Lancet 2015, 385, 239-44.
8. Slotman BJ, van Tinteren H. Which patients with extensive stage small-cell
lung cancer should and should not receive thoracic radiotherapy? Transl Lung
Cancer Res. 2015, 4, 292-4.
9. Gore EM, Hu C, Sun A, et al. NRG Oncology/RTOG 0937: Randomized phase
II study comparing prophylactic cranial irradiation (PCI) alone to PCI and
consolidative extra-cranial irradiation for extensive disease small cell lung
cancer (ED-SCLC). Proc ASTRO, Int J Radiat Oncol Biol Phys 2016, 94, 5.
Keywords: SCLC, thoracic radiotherapy, Radiotherapy
ED14: SMALL CELL LUNG CANCER
WEDNESDAY, DECEMBER 7, 2016 - 14:30-15:45
ED14.03 UPDATE ON PROPHYLACTIC CRANIAL IRRADIATION IN
SCLC
Takashi Seto
Department of Thoracic Oncology, National Kyushu Cancer Center, Fukuoka/Japan
Background: A previous study has shown that prophylactic cranial irradiation
(PCI) reduced the risk of brain metastases (BM) and prolonged the overall
survival (OS) of patients (pts) with extended disease small cell lung cancer
(ED-SCLC). However Japanese trial to reconfirm these results was stopped at
first interim analysis (n=163 pts) because of futurity. According to this study
protocol, final follow up was done. Materials and methods: From March 2009
pts with ED-SCLC who had any response to first-line chemotherapy (platinum
agent plus irinotecan or etoposide) were randomized to either PCI (25Gy/10
fractions) or observation (Obs) alone. The patients were required to prove the
absence of BM by MRI prior to enrollment. The primary endpoint was OS and a
planned sample size of 330 was determined to detect the hazard ratio (HR) of
0.75 at a significance level of 0.05 and a power of 80%. Secondary endpoints
included time to BM (evaluated every 3 months by imaging), progression-free
survival (PFS), and adverse effects (AEs) and mini mental status examination
(MMSE). Results: In Apr 2014, follow up analysis was conducted for the
survival data of 224 all enrolled pts. One hundred fourth-five deaths were
observed. The median OS was 11.6 and 14.1 months for PCI (n=112) and Obs
(n=111), respectively (HR=1.28, 95%CI= 0.95-1.72; stratified log-rank test,
P=0.107). PCI significantly reduced the risk of BM as compared to Obs (33.6%
vs 59.7% at 12 months; Gray’s test, P