SCLC: high platelet counts tied to brain metastases risk

  • Suzuki R & al.
  • Radiother Oncol
  • 12 Jun 2018

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • Patients with small-cell lung cancer (SCLC) and no brain metastases at diagnosis who have high pretreatment platelet counts have a higher risk for brain metastases, suggesting platelet counts could be used to identify which patients may be most likely to have disease progression in the brain.

Why this matters

  • A higher 2-year OS among patients with SCLC, made possible by treatment advances, requires greater vigilance in monitoring for disease recurrence, particularly in the brain.

Study design

  • 293 patients with SCLC and no brain metastases and pretreatment complete blood counts.
  • Funding: National Institutes of Health.

Key results

  • Overall, 39% developed brain metastases.
  • Brain metastases were more common among patients with high platelet counts (>270 x 109/L) compared with those with low platelet counts (≤270 x 109/L, 46% vs 32%; Log-rank P=.009).
  • 2-year brain metastasis-free survival (BMFS) rate was significantly worse for patients with high platelet counts compared with those with low counts (14.6% vs 22.1%; P=.009) and for those with high platelet-to-lymphocyte ratio (PLR, 15.9% for >119.4 vs 25.4% for ≤119.4; P=.022).
  • After multivariable analysis, high pretreatment platelet count was independently associated with worse BMFS (HR, 1.516; 95% CI, 1.024-2.245; P=.038), but high PLR was not.

Limitations

  • Single-center, retrospective analysis.

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