@article {HansenPA4854, author = {Niels-Chr. G. Hansen and Christian B. Laursen and Stefan S. Jeppesen and Erik Jakobsen}, title = {LATE-BREAKING ABSTRACT: Early relapse of non-small cell lung cancer (NSCLC) found after CNS-symptoms}, volume = {48}, number = {suppl 60}, elocation-id = {PA4854}, year = {2016}, doi = {10.1183/13993003.congress-2016.PA4854}, publisher = {European Respiratory Society}, abstract = {Background: Danish guidelines have since February 2014 recommended MR of the brain prior to curative radiotherapy in patients with NSCLC and N2-disease. More recently O{\textquoteright}Dowd et al. [Lung Cancer 86 (2014) 185{\textendash}189] have suggested MR of the brain prior to surgery no matter the stage.Aim: To study whether the introduction in 2010 of follow-up by CT of thorax and upper abdomen every three months has reduced the incidence of relapse suspected from CNS-symptoms.Results: All 827 NSCLC patients from Funen completing curative treatment from 2005 to 2013 were included. The total number of relapses found after symptoms within 24 months decreased in the 3{\textonehalf} years after the introduction of CT-based follow-up, p \< 0,001 (table), but the total fraction presenting with CNS-symptoms did not change, p = 0.296. Relapses after stage I cancer decreased (p = 0.025), while no differences or changes for stages II or III were found.Conclusion: CT-based follow-up has not reduced the incidence of relapse suspected from CNS-symptoms in stage II-IV, and therefore we suggest routine MR of the brain before curative treatment for this group of patients.Number, fractions(\%), and [95\%CI]Jan. 2005 - June 2010July 2010 - Dec. 2013Patients with intended curative treatment449378Relapse within 24 months172 (38.3\%) [33.8-43.0\%]155 (41.0\%) [36.0-46.2\%]Relapse suspected from symptoms118 (26.3\%) [22.3-30.6\%]49 (13.0\%) [9.8-16.8\%]Relapse suspected from CNS-symptoms30 (6.7\%) [4.6-9.4\%]18 (4.8\%) [2.9-7.4\%]- Stage I9 (4.1\%) [1.9-7.7\%]1 (0.6\%) [0.0-3.0\%]- Stage II7 (7.0\%) [2.9-13.9\%]6 (6.7\%) [2.5-14.1\%]- Stage III13 (10.7\%) [5.8-17.5\%]8 (9.0\%) [4.0-17.0\%]- Stage IV - with initial brain metastases1 (16.7\%) [4.2-64.1\%]3 (50.0\%) [11.8-88.2\%]}, issn = {0903-1936}, URL = {https://erj.ersjournals.com/content/48/suppl_60/PA4854}, eprint = {https://erj.ersjournals.com/content}, journal = {European Respiratory Journal} }