ESTRO 2024 - Abstract Book

S1579

Clinical - Lung

ESTRO 2024

61

Digital Poster

SII and NLR are independent prognostic markers of patients with NSCLC BM treated with GKRS

Manoela Krasteva Cholakova 1 , Maria Ilieva Mihaylova – Hristova 2 , Kiril Zhelev Zhelev 1 , Ivaylo Stanimirov Petrov 1 , Bilyana Georgieva Korabova 1 , Ivo Plamenov Petrov 3 , Iglika Spasova Mihaylova 4 , Nikolay Vladimirov Conev 5 , Ivan Shterev Donev 6 1 MHAT Heart and Brain, Radiotherapy and Radiosurgery, Pleven, Bulgaria. 2 SHAT in Oncology, Nuclear Medicine, Sofia, Bulgaria. 3 MHAT Heart and Brain, Medical Physics, Pleven, Bulgaria. 4 SHAT in Oncology, Radiotherapy, Sofia, Bulgaria. 5 UMHAT “St. Marina”, Medical Oncology, Varna, Bulgaria. 6 MHAT Nadezhda, Medical Oncology, Sofia, Bulgaria

Purpose/Objective:

The presence of inflammatory cells in a tumor can modulate both antitumor and protumor functions and alter the therapeutic response. The prognostic value of hematological inflammatory parameters has been demonstrated in the management and clinical evaluation of numerous tumors. This single study aimed to evaluate the pretreatment hematological markers of patients with brain metastatic non-small cell lung cancer (NSCLC) treated with gamma knife radiosurgery (GKRS) and follow chemotherapy, and to correlate them with clinical variables, progression-free survival (PFS), and overall survival (OS).

Material/Methods:

In this retrospective study, we performed an analysis of 82 patients with oligometastatic NSCLC, where 59 (72%) adenocarcinoma, 12 (14.6%) squamous and other 11 (13.4%) (such as large cell, adenosquamous and polymorphous), treated from January 2021 to March 2023, aiming to achieve durable local control. All patients progressed mainly in brain and were treated with GKRS. The patients after progressed treated with pembrolizumab monotherapy for second-line or further-line treatment or cisplatin/etoposide chemotherapy. The optimal cutoff values of systemic-immune inflammation index (SII), neutrophil-lymphocyte ratio (NLR) for predicting efficacy and prognosis were determined according to receiver operating characteristic (ROC) curve and the areas under the ROC curve. We used Kaplan-Meier and Cox regression models for survival analysis.

Results:

A total of 82 patients were men 50 (61%) and woman 32(39%) with the median age was 64±5. The optimal cutoff value of SII/NLR predicted PFS and OS was 1588 and 4.84. Low SII and NLR were associated with longer PFS (HR for SII = 0.48, 95%CI 0.29-0.80, P = 0.005; HR for NLR = 0.48, 95%CI 0.29-0.81, P = 0.006;) and OS (HR for SII = 0.40, 95%CI 0.23-0.70, P = 0.001; HR for NLR = 0.40, 95%CI 0.23- 0.69, P = 0.001;). NLR ≤ 4.84 and SII ≤ 1588 were independently associated with longer PFS and OS. Patients treated with chemotherapy had a significantly shorter median OS than patients with pembrolizumab (6.00 months, 95% CI: 3.92 – 8.07 vs 21.00 months, 95% CI: 9.38 – 32.61; p<0.001)