Early recurrence factors in patients with stage III non‐small cell lung cancer treated with concurrent chemoradiotherapy

Abstract

Background The clinical characteristics and risk factors for cancer recurrence have not been well evaluated regarding early recurrence in patients with unresectable locally advanced non‐small cell lung cancer (LA‐NSCLC) who receive concurrent chemoradiotherapy (CRT). The aim of this study was to determine the clinical characteristics and risk factors of patients with stage III unresectable LA‐NSCLC treated with CRT who developed early recurrence. Methods We retrospectively reviewed the clinical records of 46 patients diagnosed with stage III unresectable LA‐NSCLC treated with CRT at our center between July 2012 and July 2021. A tumor proportion score (TPS) < 50% was defined as “low expression” and a TPS > 50% was defined as “high expression.” Results A total of 17 (37.0%) patients had a confirmed recurrence within 1 year of treatment. More patients had a lower body mass index in the early recurrence group than in the later recurrence group ( p = 0.038). A higher number of patients in the late recurrence group underwent surgery after CRT ( p = 0.036). Patients with a higher TPS were more likely to experience late recurrence than early recurrence ( p = 0.001), whereas more patients with stage N3 disease were in the early recurrence group ( p = 0.011). Multivariate analysis identified lower TPS expression as an independent risk factor for early recurrence after CRT. Overall survival was prolonged in the late recurrence group ( p < 0.001). Conclusions A lower TPS may be a predictor of early recurrence after CRT in patients with LA‐NSCLC. These patients should be closely monitored for post‐treatment recurrence.

Identification of predictive factors for early relapse in patients with unresectable stage III non‐small cell lung cancer receiving consolidation durvalumab after concurrent chemoradiation therapy

“…In a recent retrospective study from a single center, lower tumor proportion score (TPS) was a factor for early relapse after CCRT in patients with unresectable stage III NSCLC. However, the proportion of patients receiving durvalumab maintenance therapy after CCRT was 36.9% (17/46) in that study 12 …”

“…First, it was a retrospective study with a small sample size. Second, clinical factors were used to investigate prognostic factors for PFS and other biomarkers, such as tumor mutation burden, gene mutations and tumor microenvironment, were not considered 10,12 . Additional studies including a larger population and further analysis with comprehensive factors associated with tumor microenvironments, host immunity, and clinical factors are required to validate our findings.…”

“…However, the proportion of patients receiving durvalumab maintenance therapy after CCRT was 36.9% (17/46) in that study. 12 Thus, in the present multicenter retrospective study, predictive factors for early relapse in unresectable stage III NSCLC patients receiving consolidation durvalumab therapy after definitive CCRT were identified.…”

“…However, the proportion of patients receiving durvalumab maintenance therapy after CCRT was 36.9% (17/46) in that study. 12 …”

Disease control in patients with non‐small cell lung cancer using pemetrexed: Investigating the best treatment strategy

“…We previously reported the potential contribution of maintaining treatment intensity to disease control and prolonged survival in maintenance therapy for lung cancer. 18,19 Therefore, we hypothesized that maintaining the treatment intensity might improve disease control in PEM therapy.…”