Inoperable early stage non-small cell lung cancer: Comorbidity, patterns of care and survival
| Autor: | T. Parhar, S.L. Smith, D.A. Palma, Elaine S. Wai, C.S. Alexander |
|---|---|
| Přispěvatelé: | Radiation Oncology, CCA - Innovative therapy |
| Rok vydání: | 2011 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine Oncology Cancer Research medicine.medical_specialty Lung Neoplasms Palliative care medicine.medical_treatment Pulmonary function testing Risk Factors Carcinoma Non-Small-Cell Lung Internal medicine Humans Medicine Stage (cooking) Lung cancer Aged Neoplasm Staging Retrospective Studies Aged 80 and over Performance status business.industry Proportional hazards model Middle Aged medicine.disease Survival Analysis Comorbidity Surgery Radiation therapy Female business |
| Zdroj: | Smith, S L, Palma, D A, Parhar, T, Alexander, C S & Wai, E S 2011, ' Inoperable early stage non-small cell lung cancer: Comorbidity, patterns of care and survival ', Lung Cancer, vol. 72, no. 1, pp. 39-44 . https://doi.org/10.1016/j.lungcan.2010.07.015 Lung Cancer, 72(1), 39-44. Elsevier Ireland Ltd |
| ISSN: | 0169-5002 |
| DOI: | 10.1016/j.lungcan.2010.07.015 |
| Popis: | To evaluate comorbidities, patterns of care and outcomes for patients with inoperable stage I and II non-small cell lung cancer (NSCLC).Patients diagnosed with stage I or II NSCLC in British Columbia between 1996 and 2005 who did not undergo primary surgery and were referred for oncology assessment were identified in a retrospective analysis. Baseline comorbidity and pulmonary function data for patients treated with curative radiotherapy (CurRT; biologically effective dose [BED]58 Gy(10)) were abstracted by chart review. Kaplan-Meier and Cox regression were used to determine factors associated with overall survival (OS) and cause-specific survival (CSS) based on treatment group [no radiotherapy (NoRT), palliative radiotherapy (PallRT), or CurRT].Of 1043 patients identified, approximately 1/3 received CurRT, and these patients had better performance status and lower stage disease than the other groups. There was a high prevalence of comorbid conditions in the CurRT group; 90% of CurRT patients had an age-adjusted Charlson comorbidity index (CCI) score ≥5. CurRT patients had a median survival 1-year longer than patients treated with PallRT or NoRT (p0.0001). In CurRT patients, CCI was predictive of OS (HR 1.1 per point CCI increase; p = 0.044), but not CSS. Patients receiving PallRT with a BED50 Gy(10) had significantly longer OS than those receiving PallRT of ≤50 Gy(10) (p0.0001).Treatment of medically inoperable early stage NSCLC patients with CurRT is associated with a significantly longer survival, and for these patients CCI is a significant predictor of OS. For patients treated with PallRT, higher doses of palliative thoracic RT is associated with improved OS. |
| Databáze: | OpenAIRE |
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