Weight Gain in Advanced Non–Small-Cell Lung Cancer Patients During Treatment With Split-Course Concurrent Chemoradiotherapy Is Associated With Superior Survival
| Autor: | Michael J. Liptay, Atif J. Khan, Mary J. Fidler, William H. Warren, Ross A. Abrams, P. Mehta, Philip Bonomi, Thomas W. Zusag, L. Penfield Faber, James C. Marsh, Benjamin T. Gielda |
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| Rok vydání: | 2011 |
| Předmět: |
Adult
Male Oncology Cancer Research medicine.medical_specialty Lung Neoplasms medicine.medical_treatment Weight Gain Disease-Free Survival Carcinoma Non-Small-Cell Lung Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Carcinoma Humans Radiology Nuclear Medicine and imaging Stage (cooking) Lung cancer Aged Neoplasm Staging Retrospective Studies Aged 80 and over Analysis of Variance Univariate analysis Radiation business.industry Remission Induction Weight change Cancer Chemoradiotherapy Middle Aged medicine.disease Surgery Radiation therapy Treatment Outcome Female business |
| Zdroj: | International Journal of Radiation Oncology*Biology*Physics. 81:985-991 |
| ISSN: | 0360-3016 |
| Popis: | Preoperative concurrent chemoradiotherapy (CRT) is an accepted treatment for potentially resectable, locally advanced, non-small-cell lung cancer (NSCLC). We reviewed a decade of single institution experience with preoperative split-course CRT followed by surgical resection to evaluate survival and identify factors that may be helpful in predicting outcome.All patients treated with preoperative split-course CRT and resection at Rush University Medical Center (RUMC) between January 1999 and December 2008 were retrospectively analyzed. Endpoints included overall survival (OS), progression-free survival (PFS), local-regional progression-free survival (LRPFS), and distant metastasis-free survival (DMFS). Patient and treatment related variables were assessed for correlation with outcomes.A total of 54 patients were analyzed, 76% Stage IIIA, 18% Stage IIIB, and 6% oligometastatic. The pathologic complete response (pCR) rate was 31.5%, and the absence of nodal metastases (pN0) was 64.8%. Median OS and 3-year actuarial survival were 44.6 months and 50%, respectively. Univariate analysis revealed initial stage (p0.01) and percent weight change during CRT (p0.01) significantly correlated with PFS/OS. On multivariate analysis initial stage (HR, 2.4; 95% CI, 1.18-4.90; p = 0.02) and percent weight change (HR, 0.79; 95% CI, 0.67-0.93; p0.01) maintained significance with respect to OS. There were no cases of Grade 3+ esophagitis, and there was a single case of Grade 3 febrile neutropenia.The strong correlation between weight change during CRT and OS/PFS suggests that this clinical parameter may be useful as a complementary source of predictive information in addition to accepted factors such as pathological response. |
| Databáze: | OpenAIRE |
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