PUB085 Outcomes of Small Cell Lung Cancer Patients with Brain Metastases: Prognostic Factors Based on an Analysis of 225 Cases

Brain metastases (BMs) are common in patients with small cell lung cancer(SCLC) and are usually fatal. The purpose of this analysis is to evaluate the outcomes of SCLC patients with BMs and explore the prognostic factors. Pathological diagnosis of SCLC patients with radiologically confirmed BMs were enrolled except those who received surgery of primary lesion. Overall Survival(OS) was calculated from the date of diagnosis of BMs to the date of death from any cause, or the last follow-up. OS was estimated by the Kaplan-Meier method. Univariate and multivariate analyses were performed by the log-rank and Cox’s proportional hazard model test, respectively. From Jan 2011 to Oct 2014, 224 patients were eligible for the study. The median follow-up time was 14 months (range,1-77). For the entire cohort, median OS was 9 months (95% CI, 7.6-10.4), 1- and 2-year OS rate were 31.2% and 7.7%, respectively. As expected, the OS of patients with oligmetastatic BMs (≤3) turned out to be significantly better compared to the survival of patients with non-oligmetastatic BM s(>3) (10 months vs 7 months, P<0.05). Similarly, median OS of patients with initial brain metastatic presentation was 11 months (95% CI, 9.4-12.6) while OS of patients with brain metastatic development during follow-up was 7 months (95% CI, 5.7-8.3), the difference was statistically significant (P=0.021). In addition, patients received radiation to brain or chemotherapy after diagnosis of BMs also had a significantly better survival rate (P<0.001). Multivariate analyses revealed sex, radiation to brain, number of BMs and chemotherapy after diagnosis of BMs were relevant parameters in predicting outcome of SCLC patients with BMs.Tabled 1Prognostic factorPatients(n)Univariate analysis(P)Multivariate analysis(P)Sex(male/female)199/250.0110.036Age(<70/≥70)198/260.951PS(0-1/2)204/200.562Thoracic radiotherapy(yes/no)81/1430.606Smoking status(never smoker /smoker)54/1700.0390.903Diagnosis of BMs (initial metastatic presentation/ metastatic development during follow-up97/1270.0210.136Symptomatic BMs(yes/no)64/1600.136Hemoglobin at diagnosis of BMs(normal/100-120g/L/80-100g/L)144/65/150.0010.083Radiation to brain(yes/no)157/670.0000.000RPA(I/II/III)40/170/140.0440.123GPA (0-1/1.5-2.5/3/3.5-4)35/138/32/190.265Number of BMs (oligmetastatic BMs/ non-oligmetastatic BMs)138/860.0260.017Volume of BMs(<337mm3/338-1592mm3/1593-11099 mm3/>11100 mm3)54/58/55/570.757Chemotherapy after diagnosis of BMs(yes/no)172/520.0000.000 Open table in a new tab In our investigated population, median OS of SCLC patients with BMs was 9 months. Therapy after diagnosis of BMs(radiation to brain or chemotherapy) could improve clinical outcomes. Meanwhile, sex and number of BMs were implicated to have an impact on survival, these may provide stratification factors in predicting prognosis in future.