2024 World Conference on Lung Cancer (WCLC) - ePosters-EP.13C.08 Leukoencephalopathy and Brain Metastasis in LS-SCLC Patients with and without PCI after Curative Thoracic RT

EP.13C.08 Leukoencephalopathy and Brain Metastasis in LS-SCLC Patients with and without PCI after Curative Thoracic RT

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The study conducted by Anneyuko I Saito MD PhD at Juntendo University investigates the impact of prophylactic cranial irradiation (PCI) on limited-stage small-cell lung cancer (LS-SCLC) patients after curative thoracic radiotherapy (RT). The focus is on the risk of leukoencephalopathy and brain metastasis in patients who receive PCI compared to those who do not.<br /><br />The research evaluates various survival metrics: overall survival (OS), progression-free survival (PFS), brain metastasis-free survival (BFS), and modified Fazekas Score (MFS), which is used to assess leukoencephalopathy. The study involved a retrospective analysis from January 2012 to December 2023, including LS-SCLC patients with performance status 0-1.<br /><br />The MRI-based evaluation was conducted by two independent neuroradiologists using the Modified Fazekas Scale, which grades deep white matter lesions. Patients showing a Fazekas score of 2 or worse before RT were excluded from the study. The final cohort included 48 patients, with a median age of 64 years.<br /><br />The results suggest that PCI is associated with improved BFS and exhibits a positive trend in PFS; however, the trend of a negative impact on MFS was noted, indicating potential neurocognitive risks associated with PCI. Specifically, the 2-year BFS significantly improved for patients with PCI (91%) compared to those without PCI (53%), with a p-value of 0.01. Conversely, the 2-year MFS was better without PCI (79% versus 16%, p=0.07).<br /><br />In conclusion, while PCI seems to enhance PFS and BFS, indicating a decrease in brain metastasis, it may lead to a worsening trend in leukoencephalopathy. Further MRI surveillance studies are suggested to better balance the benefits and risks of PCI. Ongoing studies like SWOG1827/MAVERICK are expected to provide more insights.

Asset Subtitle

Anneyuko Saito

Meta Tag

Speaker Anneyuko Saito

Topic Small Cell Lung Cancer and Neuroendocrine Tumors

Keywords

prophylactic cranial irradiation

small-cell lung cancer

leukoencephalopathy

brain metastasis

overall survival

progression-free survival

Fazekas Score

MRI evaluation

neurocognitive risks

SWOG1827/MAVERICK