e18555 Background: Limited-disease small cell lung cancer (LD-SCLC) patients who do not achieve complete remission (CR) have a considerable relapse rate. The change of tumor burden after treatment can be related with prognosis, the change of TNM stage may influence the outcome of treatment. We investigated the impact of downstaging on overall survival (OS) in LD-SCLC patients treated with chemoradiotherapy (CRT). Methods: We retrospectively reviewed the 210 LD-SCLC patients, who were treated with CRT at Seoul National University Hospital from Apr 1999 to Nov 2012. The relationship between downstaging and OS was analyzed, and subgroup analysis on the responders was performed. Results: Patients showing CR, partial remission (PR), and stable disease (SD)/progressive disease (PD) were 37.1% (n=78), 46.2% (n=97), and 16.7% (n=35), respectively. The median OS for CR, PR, and SD/PD were 47.9 months (mo), 21.8 mo, and 11.2 mo, respectively (P <0.001). Patients showing downstaging and no change/upstaging were 61.5% (n=129) and 38.5% (n=81), respectively. The median OS for downstaging and no change/upstaging were 36.5 mo and 14.4 mo, respectively (P <0.001). Among the 97 patients achieving PR, OS were statistically differed by downstaging (26.0 mo in patients with downstaging and 17.7 mo in patients without downstaging [P =0.021]). In the multivariate analyses, female, downstaging, lower initial TNM stage, and prophylactic cranial irradiation were independent good prognostic factors for OS. Conclusions: Downstaging was independent prognostic factor in LD-SCLC. Especially, downstaging is useful for further stratification of patients achieving PR. Additional treatments after CRT may be needed for the patients who achieving PR without downstaging.
Correlation of Clinical Parameters with Intracranial Outcome in Non-Small Cell Lung Cancer Patients with Brain Metastases Treated with Pd-1/Pd-L1 Inhibitors as Monotherapy
