e21167 Background: The role of thoracic radiotherapy in the treatment of metastatic EGFR mutant non-small cell lung cancer patients in literature datas are insufficient.The aim of this study was to examine the effectiveness of upfront thoracic radiotherapy in metastatic EGFR mutant NSCLC patients treated with chemotherapy or TKI. Methods: This study was designed as a hospital-based retrospective observational case-series study. A total of 141 patients with metastatic EGFR mutant non-small cell lung cancer who has followed in two different oncology centers at Turkey between 2014 and 2020. have been included to this study. Results: The median age of the patients was 63 (range 35-91) years. EGFR mutation results of exon 19 deletion, exon 21 mutation and exon 18 mutation were found in 82 (58.2%), 56 (39.7%) and 3 (2.1%) patients, respectively. The median follow-up time was 22 months and 94 (33.3%) patients died during follow-up. Median overall survival (OS) was 26 months and progression free survival (for first line treatment) (PFS) was 10 months for whole patients, respectively. Radiotherapy was given to the primary tumor site in 32 (22,6%) patients. Patients receiving radiotherapy to primary tumor site had better overall survival than those not (31 versus 23 months respectively and p = 0,02) The survival advantage was also seen for patients group taking TKI at upfront setting (33 versus 23 months respectively and p = 0.05). Conclusions: In this study, we have showed that upfront thoracic radiotherapy to primary lession as combination with EGFR-TKI treatment may improve the outcome in advanced stage IV NSCLC patients harboring EGFR mutations.
68 Background: The aim was to assess the intensity of 68Ga-PSMA uptake in the primary tumour in patients locally advanced prostate cancer treated with definitive radiotherapy. Also correlation between the maximum standardized uptake value (SUVmax) of primary tumour and the Gleason score (GS) or prostate-specific antigen (PSA) level was assessed. Methods: The data of 201 biopsy-proven prostated cancer patients were retrospectively analysed. Median age of entire cohort was 68 years (range; 45 – 85 years). PET/CT images were analysed visually and semiquantitatively by measuring the SUVmax. The SUVmax of the primary tumour was assessed in relation to both PSA level and GS. Results: Median age of entire cohort was 68 years (ranged 45 – 85 years). Median PSA value at diagnosis was 20.3 ng/mL (ranged 2.1 – 301.0 ng/mL). Forty-two patients (23.9%) was in intermediate risk group, and 159 patients (79.1%) had high risk disease. Seventy two patients (36.8%) had regional lymph node metastasis. Median SUVmax of primary tumor and metastatic lymph nodes were 13.0 (ranged 1.3 - 84.3) and 12.6 (ranged 3.6 – 64.5), respectively. Patients with GS 7 or lower had significantly lower SUVmax compared to patients with GS > 7 (12.1±8.4 vs. 20.9±16.4; p < 0.001). However, there was no significant difference in SUVmax of tumors with GS of 3+4 and 4+3 (14.8±8.6 vs. 16.3±12.7; p = 0.6). Patients with PSA ≥10.0 ng/mL exhibited significantly higher uptake than those with PSA levels < 10.0 ng/mL (12.1±8.4 vs. 20.9±16.4; p < 0.001). SUVmax of intermediate risk patients was significantly lower than that of high risk patients (12.7±11.1 vs. 19.8±16.8; p = 0.01). In 72 patients with lymph node metastasis SUVmax was significantly higher compared to 129 patients without lymph node metastasis (24.9±21.3 vs. 14.7±10.6; p < 0.001). Conclusions: Tumours with GS 7 or lower, patients with PSAvalues ≤10 ng/mL, intermediate risk patients and patients without regional lymph node metastasis showed significantly lower 68Ga-PSMA uptake. 68Ga-PSMA-PET/CT should be preferentially applied for primary staging of prostate cancer in patients with GS > 7, PSA levels ≥10 ng/ml, high risk patients and patients with regional lymph node metastasis.
79 Background: The implementation of 68Ga-PSMA-PET-imaging for staging and the impact on stage adaption during treatment radiotherapy (RT) planning is not well studied yet. The present work is to evaluate the integration of 68Ga-PSMA-PET into standard RT planning and to determine the influence on staging and on changes in the initially planned treatment concept for definitive RT in prostate cancer patients. Methods: A total of 66 prostate cancer patients with PSMA-PET delivered before treatment were retrospectively analyzed. All patients had bone scintigraphy and magnetic resonance imaging (MRI) of abdomen (52 patients; 79%) or thoraco-abdominal computed tomography (CT) (14 patients; 21%). After PSMA-imaging, all information was reviewed and re-classification was performed with the additional information taken into account. Thereafter, patients were evaluated with the information obtained by PSMA-PET imaging led to a change in staging and subsequently resulted in a change of the RT concept and treatment fields. Results: Median age of patients was 66 years (range 46 – 84 years). Median pretreatment PSA level was 25.2 ng/mL (range 4.4 – 130.8 ng/mL). The initial stage was changed in 27 patients (41%); 8 patients (12%) under-staged, 11 patients (17%) over-staged and 8 patents (12%) had distant metastasis. RT fields changed in 9 patients (14%) and RT cancelled because of distant metastasis detected with PSMA-PET in 6 patients (9%). The mean pretreatment PSA values were significantly higher in over-staged patients or patient with distant metastasis compared to under-staged patients (55.0±38.8 ng/mL vs. 28.1±19.1 ng/mL; p = 0.02). Also upstaging was observed more frequently in patients with ≥ T3a disease compared to patients with < T3 disease (15 patients [56%] vs. 4 patients [15%]; p = 0.04). However, Gleason score and primary tumor SUV had no significant impact on stage change and particularly on RT decision and treatment plan changes. Conclusions: The performance of a PSMA-PET frequently leads to changes in the stage, altering the RT treatment regimen especially in patients with extensive stage disease and higher pretreatment PSA values.
308 Background: The aim of this study is to evaluate the prognostic implications of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) at baseline and after 4 and 12 weeks of treatment with abiraterone in patients with metastatic castration-resistant prostate cancer (mCRPC). Methods: We retrospectively evaluated 102 mCRPC treated with abiraterone either pre- or post-chemotherapy between November 2012 and October 2017 in three institutions. We calculated NLR and PLR at baseline and at 4 and 12 weeks after initiation of abiraterone, and we evaluated prostate-specific antigen (PSA) response every 4 weeks. Fifty patients (49%) were treated with abiraterone post-docetaxel, and 52 patients (51%) received abiraterone pre-chemotherapy. Based on receiver operating characteristic analysis, patients were stratified as low NLR ( < 3.1) or high NLR (≥ 3.1), and low PLR ( < 163) or high PLR (≥ 163). The cutoff for anemia was < 12g/dL. Results: Median follow-up times for patients overall and for those who survived were 24.0 months (range, 0.3 – 54.9 months) and 25.5 months (range, 2.8 – 54.9 months), respectively. The median time of abiraterone treatment was 8.1 months (range, 2.4 – 40.1 months). The median overall survival (OS) was 20.8 months (interquartile range: 17.3–24.4). In univariate analysis, NLR, PLR, PSA response, and low hemoglobin (Hgb) were found significantly predictive of OS and progression-free survival (PFS). In multivariate analysis, declines in NLR and PSA of ≥ 90% emerged as significant independent predictors of OS and PFS. High-NLR patients who remained high or who returned to low NLR after 4 and 12 weeks showed significantly worse OS than patients with low baseline NLR. Patients with baseline Hgb > 12 g/dL had significantly longer median OS compared with patients with Hgb ≤ 12 g/dL; however, the significance of Hgb was lost at 12 weeks. Conclusions: NLR and PSA response to abiraterone was a significant predictor of OS and PFS in mCRPC patients treated with abiraterone delivered either pre- or post-chemotherapy. Furthermore, persistent increase in NLR during abiraterone has prognostic value for OS in patients with mCRPC.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.