Vol 70, No 4 (2020)
Research paper (original)
Published online: 2020-07-27
Survival analysis of patients with locally advanced non-small cell lung cancer treated at the Nu-Med Radiotherapy Center in Elbląg
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Nowotwory. Journal of Oncology 2020;70(4):135-143.
Abstract
Introduction. The study aimed to report the efficiency of radical radiotherapy and chemoradiotherapy in patients with non-small cell lung cancer (NSCLC) treated in the Nu-Med Radiotherapy Center in Elbląg.
Material and methods. Ninety-two patients diagnosed with NSCLC treated between 2013 and 2016 were included in the analysis. Overall survival (OS) was estimated by the Kaplan-Meier method.
Results. The 2-year OS for all patients was 36% (median 1.5 years). Two prognostic factors had a significant impact: treatment method and performance status (PS). Patients who underwent concurrent radiochemotherapy and were treated sequentially had a better 2-year OS in comparison with those treated with radiotherapy alone (respectively 46% and 37% vs. 25%, p ≤ 0.05). Patients with PS 0–1 had better OS (median 1.6 years) compared with PS 2 (median 0.7 years, p = 0.04). Other prognostic factors analysed had no impact on OS in our study.
Conclusions. The treatment results of our patients are comparable to those in published trials and meta-analyses.
Keywords: non-small cell lung cancerchemoradiotherapyradiotherapyoverall survival
References
- Krajowy Rejestr Nowotworów - Nowotwory złośliwe opłucnej i płuca (C33-34). http://onkologia.org.pl/nowotwory-zlosliwe-oplucnej-pluca-c33-34/.
- Alberg AJ, Brock MV, Ford JG, et al. Epidemiology of lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2013; 143(5 Suppl): e1S–e29S.
- Moura MA, Bergmann A, Aguiar SS, et al. The magnitude of the association between smoking and the risk of developing cancer in Brazil: a multicenter study. BMJ Open. 2014; 4(2): e003736.
- Ginsberg JR. Thoracic surgery. Churchill-Livingstone, Philadelphia 2002.
- EUROCARE - Survival of cancer patients in Europe. https://w3.iss.it/site/EU5Results/forms/SA0007.aspx.
- Krzakowski M, Jassem J, Dziadziuszko R. et al. Nowotwory płuca i opłucnej oraz śródpiersia. 20013: 71.
- Yang P, Allen MS, Aubry MC, et al. Clinical features of 5,628 primary lung cancer patients: experience at Mayo Clinic from 1997 to 2003. Chest. 2005; 128(1): 452–462.
- Gray JE, Villegas A, Daniel D, et al. PACIFIC Investigators. Overall Survival with Durvalumab after Chemoradiotherapy in Stage III NSCLC. N Engl J Med. 2018; 379(24): 2342–2350.
- Feinstein AR, Sosin DM, Wells CK. The Will Rogers phenomenon. Stage migration and new diagnostic techniques as a source of misleading statistics for survival in cancer. N Engl J Med. 1985; 312(25): 1604–1608.
- Eberhardt WEE, De Ruysscher D, Weder W, et al. Panel Members. 2nd ESMO Consensus Conference in Lung Cancer: locally advanced stage III non-small-cell lung cancer. Ann Oncol. 2015; 26(8): 1573–1588.
- Blanke CD, Johnson DH. Combined modality therapy in non-small cell lung cancer. Curr Opin Oncol. 1995; 7(2): 144–149.
- Cakir S, Egehan I. A randomised clinical trial of radiotherapy plus cisplatin versus radiotherapy alone in stage III non-small cell lung cancer. Lung Cancer. 2004; 43(3): 309–316.
- Groen HJM, van der Leest AHW, Fokkema E, et al. Continuously infused carboplatin used as radiosensitizer in locally unresectable non-small-cell lung cancer: a multicenter phase III study. Ann Oncol. 2004; 15(3): 427–432.
- Dillman RO, Seagren SL, Propert KJ, et al. A randomized trial of induction chemotherapy plus high-dose radiation versus radiation alone in stage III non-small-cell lung cancer. N Engl J Med. 1990; 323(14): 940–945.
- O'Rourke N, Roqué I Figuls M, Farré Bernadó N, et al. Concurrent chemoradiotherapy in non-small cell lung cancer. Cochrane Database Syst Rev. 2010(6): CD002140.
- Huber RM, Flentje M, Schmidt M, et al. Bronchial Carcinoma Therapy Group. Simultaneous chemoradiotherapy compared with radiotherapy alone after induction chemotherapy in inoperable stage IIIA or IIIB non-small-cell lung cancer: study CTRT99/97 by the Bronchial Carcinoma Therapy Group. J Clin Oncol. 2006; 24(27): 4397–4404.
- Curran WJ, Paulus R, Langer CJ, et al. Sequential vs. concurrent chemoradiation for stage III non-small cell lung cancer: randomized phase III trial RTOG 9410. J Natl Cancer Inst. 2011; 103(19): 1452–1460.
- Aupérin A, Le Péchoux C, Rolland E, et al. Meta-analysis of concomitant versus sequential radiochemotherapy in locally advanced non-small-cell lung cancer. J Clin Oncol. 2010; 28(13): 2181–2190.
- Belani CP, Wang W, Johnson DH, et al. Eastern Cooperative Oncology Group. Phase III study of the Eastern Cooperative Oncology Group (ECOG 2597): induction chemotherapy followed by either standard thoracic radiotherapy or hyperfractionated accelerated radiotherapy for patients with unresectable stage IIIA and B non-small-cell lung cancer. J Clin Oncol. 2005; 23(16): 3760–3767.
- Provencio M, Isla D, Sánchez A, et al. Inoperable stage III non-small cell lung cancer: Current treatment and role of vinorelbine. J Thorac Dis. 2011; 3(3): 197–204.
- Gouda YS, Kohail HM, Eldeeb NA, et al. Randomized study of concurrent carboplatin, paclitaxel, and radiotherapy with or without prior induction chemotherapy in patients with locally advanced non-small cell lung cancer. J Egypt Natl Canc Inst. 2006; 18(1): 73–81.
- Jalal SI, Riggs HD, Melnyk A, et al. Hoosier Oncology Group, US Oncology. Phase III study of cisplatin, etoposide, and concurrent chest radiation with or without consolidation docetaxel in patients with inoperable stage III non-small-cell lung cancer: the Hoosier Oncology Group and U.S. Oncology. J Clin Oncol. 2008; 26(35): 5755–5760.
- Bradley JD, Paulus R, Komaki R, et al. Standard-dose versus high-dose conformal radiotherapy with concurrent and consolidation carboplatin plus paclitaxel with or without cetuximab for patients with stage IIIA or IIIB non-small-cell lung cancer (RTOG 0617): a randomised, two-by-two factorial phase 3 study. Lancet Oncol. 2015; 16(2): 187–199.
- Walraven I, Damhuis RA, Ten Berge MG, et al. Treatment Variation of Sequential versus Concurrent Chemoradiotherapy in Stage III Non-Small Cell Lung Cancer Patients in the Netherlands and Belgium. Clin Oncol (R Coll Radiol). 2017; 29(11): e177–e185.
- Osowiecka K, Rucińska M, Każarnowicz A, et al. Przeżycia chorych na niedrobnokomórkowego raka płuca leczonych napromienianiem w latach 2003–2006 w Samodzielnym Publicznym Zakładzie Opieki Zdrowotnej Ministerstwa Spraw Wewnętrznych z Warmińsko-Mazurskim Centrum Onkologii w Olsztynie. NOWOTWORY J Oncol. 2015; 65(1): 14–22.