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Routine Neuroimaging in Patients with Stage IV Non-Small Cell Lung Cancer: A Single Center Experience

Background: There is a lack of consensus in current practice guidelines regarding routine neuroimaging in patients with stage IV non-small cell lung cancer (NSCLC) without neurologic symptoms, and there is a paucity of data on the impact of such imaging on overall survival (OS). Methods: This retros...

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Autores principales: Dubé-Pelletier, Maude, Labbé, Catherine
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8025755/
https://www.ncbi.nlm.nih.gov/pubmed/33801445
http://dx.doi.org/10.3390/curroncol28020108
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author Dubé-Pelletier, Maude
Labbé, Catherine
author_facet Dubé-Pelletier, Maude
Labbé, Catherine
author_sort Dubé-Pelletier, Maude
collection PubMed
description Background: There is a lack of consensus in current practice guidelines regarding routine neuroimaging in patients with stage IV non-small cell lung cancer (NSCLC) without neurologic symptoms, and there is a paucity of data on the impact of such imaging on overall survival (OS). Methods: This retrospective study included 257 patients with stage IV NSCLC without neurologic symptoms diagnosed between January 1, 2013 and December 31, 2016 at Institut universitaire de cardiologie et de pneumologie de Québec (IUCPQ). The primary objective of this study was to compare the evolution of patients with stage IV NSCLC who had baseline brain imaging versus with who did not. Secondary objectives were to determine the proportion of patients who underwent brain imaging in their initial investigation and the proportion of patients who developed metachronous central nervous system (CNS) metastasis. Results: CNS imaging, mainly with computed tomography (CT), was performed at diagnosis in 56% of patients, and the prevalence of synchronous CNS metastasis among these patients was 32%. There was no difference in median OS between patients who underwent initial CNS imaging and those who did not, but we did show a tendency for a higher cumulative incidence of metachronous CNS metastasis in patients without baseline imaging. These metachronous metastases were symptomatic and were more often not treated when compared to synchronous metastases. Conclusions: In this small, unicentric retrospective study, there was no benefit with routine neuroimaging in terms of median OS in stage IV NSCLC patients without neurologic symptoms.
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spelling pubmed-80257552021-04-08 Routine Neuroimaging in Patients with Stage IV Non-Small Cell Lung Cancer: A Single Center Experience Dubé-Pelletier, Maude Labbé, Catherine Curr Oncol Article Background: There is a lack of consensus in current practice guidelines regarding routine neuroimaging in patients with stage IV non-small cell lung cancer (NSCLC) without neurologic symptoms, and there is a paucity of data on the impact of such imaging on overall survival (OS). Methods: This retrospective study included 257 patients with stage IV NSCLC without neurologic symptoms diagnosed between January 1, 2013 and December 31, 2016 at Institut universitaire de cardiologie et de pneumologie de Québec (IUCPQ). The primary objective of this study was to compare the evolution of patients with stage IV NSCLC who had baseline brain imaging versus with who did not. Secondary objectives were to determine the proportion of patients who underwent brain imaging in their initial investigation and the proportion of patients who developed metachronous central nervous system (CNS) metastasis. Results: CNS imaging, mainly with computed tomography (CT), was performed at diagnosis in 56% of patients, and the prevalence of synchronous CNS metastasis among these patients was 32%. There was no difference in median OS between patients who underwent initial CNS imaging and those who did not, but we did show a tendency for a higher cumulative incidence of metachronous CNS metastasis in patients without baseline imaging. These metachronous metastases were symptomatic and were more often not treated when compared to synchronous metastases. Conclusions: In this small, unicentric retrospective study, there was no benefit with routine neuroimaging in terms of median OS in stage IV NSCLC patients without neurologic symptoms. MDPI 2021-03-02 /pmc/articles/PMC8025755/ /pubmed/33801445 http://dx.doi.org/10.3390/curroncol28020108 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ).
spellingShingle Article
Dubé-Pelletier, Maude
Labbé, Catherine
Routine Neuroimaging in Patients with Stage IV Non-Small Cell Lung Cancer: A Single Center Experience
title Routine Neuroimaging in Patients with Stage IV Non-Small Cell Lung Cancer: A Single Center Experience
title_full Routine Neuroimaging in Patients with Stage IV Non-Small Cell Lung Cancer: A Single Center Experience
title_fullStr Routine Neuroimaging in Patients with Stage IV Non-Small Cell Lung Cancer: A Single Center Experience
title_full_unstemmed Routine Neuroimaging in Patients with Stage IV Non-Small Cell Lung Cancer: A Single Center Experience
title_short Routine Neuroimaging in Patients with Stage IV Non-Small Cell Lung Cancer: A Single Center Experience
title_sort routine neuroimaging in patients with stage iv non-small cell lung cancer: a single center experience
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8025755/
https://www.ncbi.nlm.nih.gov/pubmed/33801445
http://dx.doi.org/10.3390/curroncol28020108
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