ESTRO 2024 - Abstract Book

S739

Clinical - CNS

ESTRO 2024

52

Digital Poster

Sarcopenia as an independent prognostic marker in NSCLC patients with BMs treated with GKRS

Kiril Zhelev Zhelev 1 , Manoela Krasteva Cholakova 1 , Bilyana Georgieva Korabova 1 , Roumen Metodiev Lazarov 1 , Maria Ilieva Mihaylova-Hristova 2 , Iglika Spasova Mihaylova 3 , Nikolay Vladimirov Conev 4 , Mila Petrova Petrova 5 , Ivan Shterev Donev 5 1 MHAT Heart and Brain, Radiotherapy and Radiosurgery, Pleven, Bulgaria. 2 SHAT of Oncology, Nuclear Medicine, Sofia, Bulgaria. 3 SHAT of Oncology, Radiotherapy, Sofia, Bulgaria. 4 UMHAT St.Marina, Medical Oncology, Varna, Bulgaria. 5 MHAT Nadezhda, Medical Oncology, Sofia, Bulgaria

Purpose/Objective:

Low muscle mass (sarcopenia) is a syndrome associated with poor outcome in cancer patients. Temporal muscle thickness (TMT) is a novel biomarker of sarcopenia, however its significance in patients with brain metastasis (BMs) has not been thoroughly investigated. The purpose of this retrospective study was to evaluate prognostic performance of sarcopenia in patients with BMs from non-small cell lung cancer (NSCLC) treated with Gamma Knife radiosurgery (GKRS).

Material/Methods:

In this single study, we analyzed 82 patients with BMs from NSCLC in the period between January 2021 and February 2023, of which 59 (72%) were with adenocarcinoma, 12 (14.6%) were with squamous, 6 (7.3%) were with large cell, and 5 (6.1%) were other histology. On planning brain magnetic resonance imaging scans obtained prior to GKRS, TMT values were retrospectively determined. TMT was evaluated as a measurement on cranial thin T1WI contrast-enhanced image through multiplanar reformation. Using median value of bilateral TMT (9.85mm) as cutoff, the study cohort was divided into patients with sarcopenia and those with normal muscle status. We used Kaplan Meier and Cox regression models for survival analysis. Overall survival (OS) was defined as the interval between GKRS treatment of the disease and death or date of last follow-up evaluation. Treatment after GKRS was: 47 (57.3%) patients on immune checkpoint inhibitors and 35 (42.7%) patients on chemotherapy. The median follow- up was 12 months.

Results:

The cohort included 50 men (61%) and 32 women (39%), with a total mean age of 64±5 years. Patients with Karnofsky Performance Status (KPS) 90 were 33 (40.2%), KPS 80 - 30 (36.6%) and KPS 70 - 19 (23.2%). Patients with extra cranial metastasis (ECM) were 69 (84.1%) and dose without – 13 (15.9%). The presence of sarcopenia was related to KPS (p<0.001) as well as the presence of ECM (p=0.013). Patients with sarcopenia had a significantly shorter median OS than patients without sarcopenia (6.00 months, 95% CI: 5.37 – 7.96 vs 18.00 months, 95% CI: 18.13 – 27.26; p<0.001) (HR=7.02, 95% CI 3.58-13.78; p<0.001). Moreover, when controlling for age, gender, KPS, and number of BMs, the presence of sarcopenia was independent poor prognostic marker in multiple Cox regression model (HR=2.43, 95% CI 1.02-5.74; p<0.043).