Development of symptomatic brain metastases after chemoradiotherapy for stage III non-small cell lung cancer: Does the type of chemotherapy regimen matter?

Autor: Hendriks LEL; Dept. of Pulmonary Diseases, GROW ⿿ School for Oncology and Developmental Biology, Maastricht University Medical Center+, PO Box 5800, 6202 AZ Maastricht, The Netherlands. Electronic address: lizza.hendriks@mumc.nl., Brouns -JWM; Dept. of Pulmonary Diseases, Zuyderland Medical Center location Heerlen, PO Box 5500, 6130 MB Sittard-Geleen, The Netherlands. Electronic address: a.brouns@zuyderland.nl., Amini M; Dept. of Pulmonary Diseases, Jeroen Bosch Hospital, PO Box 90153, 5200 ME ⿿s Hertogenbosch, The Netherlands. Electronic address: M.Amini@jbz.nl., Uyterlinde W; Dept. of Thoracic Oncology, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, PO Box 90203, 1006 BE Amsterdam, The Netherlands. Electronic address: W.uyterlinde@nki.nl., Wijsman R; Dept. of Radiation Oncology, Radboud University Hospital, PO Box 9100, 6500 HA Nijmegen, The Netherlands. Electronic address: Robin.Wijsman@radboudumc.nl., Bussink J; Dept. of Radiation Oncology, Radboud University Hospital, PO Box 9100, 6500 HA Nijmegen, The Netherlands. Electronic address: Jan.Bussink@radboudumc.nl., Biesma B; Dept. of Pulmonary Diseases, Jeroen Bosch Hospital, PO Box 90153, 5200 ME ⿿s Hertogenbosch, The Netherlands. Electronic address: b.biesma@jbz.nl., Oei SB; Dept. of Radiation Oncology, Institute Verbeeten, PO Box 90120, 5000 LA Tilburg, The Netherlands. Electronic address: oei@bvi.nl., Stigt JA; Dept. of Pulmonary Diseases, Isala Clinics, PO Box 10400, 8000 GK Zwolle, The Netherlands. Electronic address: j.a.stigt@isala.nl., Bootsma GP; Dept. of Pulmonary Diseases, Zuyderland Medical Center location Heerlen, PO Box 5500, 6130 MB Sittard-Geleen, The Netherlands. Electronic address: g.bootsma@zuyderland.nl., Belderbos JSA; Dept. of Radiation Oncology, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, PO Box 90203, 1006 BE Amsterdam, The Netherlands. Electronic address: j.belderbos@nki.nl., De Ruysscher DKM; Dept. of Radiation Oncology (MAASTRO Clinic), GROW ⿿ School for Oncology and Developmental Biology, Maastricht University Medical Center+, PO Box 3035, 6202 NA Maastricht, The Netherlands. Electronic address: dirk.deruysscher@maastro.nl., Van den Heuvel MM; Dept. of Thoracic Oncology, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, PO Box 90203, 1006 BE Amsterdam, The Netherlands. Electronic address: m.vd.heuvel@nki.nl., Dingemans AC; Dept. of Pulmonary Diseases, GROW ⿿ School for Oncology and Developmental Biology, Maastricht University Medical Center+, PO Box 5800, 6202 AZ Maastricht, The Netherlands. Electronic address: a.dingemans@mumc.nl.
Jazyk: angličtina
Zdroj: Lung cancer (Amsterdam, Netherlands) [Lung Cancer] 2016 Nov; Vol. 101, pp. 68-75. Date of Electronic Publication: 2016 Sep 09.
DOI: 10.1016/j.lungcan.2016.09.008
Abstrakt: Objectives: Symptomatic brain metastases (BM) occur frequently after chemoradiotherapy (CRT) for stage III NSCLC. Aim of the current study was to determine whether the specific chemotherapy used in a CRT regimen influences BM development.
Materials and Methods: Retrospective multicenter study including all consecutive stage III NSCLC who completed CRT. Primary endpoints: symptomatic BM development, whether this was the only site of first relapse. Differences between regimens were assessed with a logistic regression model including known BM risk factors and the specific chemotherapy: concurrent versus sequential (cCRT/sCRT), within cCRT: daily low dose cisplatin (LDC)-cyclic dose polychemotherapy; LDC-(non-)taxane cyclic dose; LDC-polychemotherapy subgroups of ≥50 patients.
Results: Between January 2006 and June 2014, 838 patients were eligible (737 cCRT, 101 sCRT). 18.2% developed symptomatic BM, 8.0% had BM as only site of first relapse. BM patients were significantly younger, female, had more advanced N-stage and had adenocarcinoma histology. In both cCRT and sCRT BM were found in 18% (p=0.904). In cyclic dose cCRT (N=346) and LDC (N=391) BM were found in 18.8% and 17.9%, respectively (p=0.757). In 7.2% and 8.7%, respectively, BM were the only site of first relapse (p=0.463). The chemotherapy used (cCRT versus sCRT) had no influence on BM development, not for all brain relapses nor as only site of first relapse (OR 0.88 (p=0.669), OR 0.93 (p=0.855), respectively). LDC versus cyclic dose cCRT was not significantly different: neither for all brain relapses nor as only site of first relapse (OR 0.96 (p=0.819), OR 1.21 (p=0.498), respectively). Comparable results were found for LDC versus cyclic dose non-taxane (N=277) and cyclic dose taxane regimens (N=69) and for cCRT regimens with ≥50 patients (LDC versus cisplatin/etoposide (N=188), cisplatin/vinorelbin (N=65), weekly cisplatin/docetaxel (N=60)).
Conclusion: approximately 18% developed symptomatic BM after stage III diagnosis, not dependent on type of chemotherapy regimen used within a CRT treatment.
(Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)
Databáze: MEDLINE
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