Tetsuya Komatsu, Presenter: Nothing to Disclose

Etsuo Kunieda, Abstract Co-Author: Nothing to Disclose

Yukio Oizumi, Abstract Co-Author: Nothing to Disclose

Yoshifumi Tamai, Abstract Co-Author: Nothing to Disclose

Takeshi Akiba, Abstract Co-Author: Nothing to Disclose

Asuka Kogawa, Abstract Co-Author: Nothing to Disclose

PurposeWe analyzed the survival after radiotherapy in lung cancer patients with bone metastasis with regard to the concept of oligometastasis and the effect of Epidermal Growth Factor Recepter(EGFR)-targeted therapy.MethodsWe analyzed 132 patients with pathologically confirmed lung cancer who completed the prescribed radiotherapy dose for bone metastasis from January 1, 2004 to January 5, 2009.The survival rate after radiotherapy was calculated using the Kaplan-Meier method. The log rank test was used for univariate analysis, and the Cox proportional hazard model was used for multivariate analysis.The following variables were evaluated(subgroup are provided in parentheses): treatment for primary site (surgery vs. others), treatment site (spine vs. others), number of bone metastasis (solitary vs. multiple), number of metastatic organs (0 vs. 1 vs. ≥2 ), neurological symptoms(no symptoms vs. numbness vs. paresis), degree of pain (no pain vs. mild vs. severe), performance status (PS; 0−1 vs. ≥2), biological effective dose (BED; ≥40 Gy vs. <40 Gy), time to distant metastasis (≥1 year versus <1 year), and histology (Adenocarcinoma vs. others).In addition, subgroup analysis confined to patients with adenocarcinoma was performed to estimate the effect of the EGFR-targeted agents.Furthermore, stratified analysis was performed with each variable to detect the subgroup in which BED affected the survival rate.ResultsThe median follow-up period was 5 months (range, 1−52 months).The median survival time was 5 months. Survival rate was 25% at 1 year and 15% at 2 years.In univariate analysis, each variable excluding the treatment site showed a significant difference. The survival rate was higher for the following subgroups among these variables: surgery in treatment for primary site, solitary metastasis in number of bone metastasis, PS 0-1 in PS, ≥40 Gy in BED, ≥1 year in time to distant metastasis, and adenocarcinoma in histology, 0 in number of metastatic organs, no symptom and numbness in neurological symptoms, and no pain in degree of pain. Patients who were administered EGFR-targeted agents showed a better prognosis.In multivariate analysis, the number of bone metastasis, PS, BED, and histology showed a significant difference.In the multivariate analysis confined to patients with adenocarcinoma, EGFR-targeted agents were significant covariates.A stratified analysis was performed to determine the subgroup affected by BED. BED influenced the survival rate except in patients with ≥2 metastatic organs, paresis, no pain and poor PS. In all other strata, BED≥40 Gy showed a better prognosis than BED<40 Gy.ConclusionExcept for the patients with poor PS or multiple organ metastasis, there is a possibility that there are subgroups of patients who should be treated with curative intent.

Komatsu, T, Kunieda, E, Oizumi, Y, Tamai, Y, Akiba, T, Kogawa, A, Analysis of Survival after Radiotherapy in Lung Cancer Patients with Bone Metastasis.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11030338.html