Nomogram Predicting Overall Survival Benefit of Stereotactic Ablative Radiotherapy for Early-Stage Non-Small Cell Lung Cancer
| Autor: | Kurren Mehta, Junheng Gao, Joseph K. Salama, Corbin D. Jacobs, Chris R. Kelsey, Xiaofei Wang, Jordan A. Torok |
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| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
Pulmonary and Respiratory Medicine Oncology Adult Male Cancer Research medicine.medical_specialty Lung Neoplasms medicine.medical_treatment Logistic regression SABR volatility model Radiosurgery 03 medical and health sciences 0302 clinical medicine Internal medicine Carcinoma Non-Small-Cell Lung medicine Humans Stage (cooking) Lung cancer Aged Neoplasm Staging Receiver operating characteristic business.industry Cancer Nomogram Middle Aged medicine.disease Radiation therapy Nomograms 030104 developmental biology Treatment Outcome 030220 oncology & carcinogenesis Female business |
| Zdroj: | Clinical lung cancer. 23(2) |
| ISSN: | 1938-0690 |
| Popis: | To develop and validate a nomogram that predicts overall survival (OS) for patients with early-stage non-small cell lung cancer (NSCLC) treated with stereotactic ablative radiotherapy (SABR) vs. observation.Adults with biopsy-proven T1-T2N0 NCSLC treated with SABR (30-70 Gy in 1-10 fractions with biologically effective dose ≥100 GyA total of 22,073 adults met inclusion criteria and 4418 matched pairs (total n = 8836) were identified for nomogram development. The factors most strongly associated with improved OS on multivariable analysis included younger age (HR 0.82 by decade, P.001), female sex (HR 0.81, P.001), lower comorbidity index (HR 0.65 for 0 vs. ≥3, P.001), smaller tumor size (HR 0.60 for ≤3 cm vs. 5.1-7 cm, P.001), adenocarcinoma histology (P.001), and receipt of SABR (P.001). Interaction between SABR and histology was significantly associated with OS (P = .017). Relative to adenocarcinoma, patients with squamous cell carcinoma who were observed (HR 1.44, 95% CI 1.33-1.56) or treated with SABR (HR 1.24, 95% CI 1.14-1.35) had significantly worse OS. The nomogram demonstrated fair accuracy for predicting OS, with an integrated time-dependent AUC of 0.694 over the entire follow-up period.This nomogram estimates OS at 2 and 5 years based on whether medically inoperable early-stage NSCLC patients receive SABR or elect for observation. Incorporation of other variables not captured within the NCDB may improve the model accuracy. |
| Databáze: | OpenAIRE |
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