Prognostic Factors and Survival in Non-Small Cell Lung Cancer Patients Treated with Chemoradiotherapy

Abstract

BACKGROUND:According to the literature, performance status, stage-tumor dimension and nodal status, weight loss, were the most important prognostic factors for survival in patients with locally advanced non-small cell lung cancer.AIM:To evaluate the treatment results and the prognostic variables in our patients treated with sequential and concurrent chemoradiotherapy.MATERIAL AND METHODS:In the study 85 patients were randomly assigned to one of the two treatment arms. In the sequential arm, 45 patients had previously received sequential chemotherapy with 4 cycles of and etoposide followed by conformal radiotherapy (RT). In the second concurrent group, 40 patients received concomitant chemotherapy of cisplatine and etoposide and conformal RT, followed by two cycles of consolidation chemotherapy of carboplatine and etoposide. We described all phases of the conformal three dimensional (3-D) RT.RESULTS:From October 2005 to March 2008, 93 patients were enrolled. Eight patients were not eligible, seven had stage IV and one patient had pleural effusion. They were all initially considered to have stage IIIB disease. The median survival was 13 months for the patients in the sequential arm and 19 months for those in the concurrent treatment arm. The differences were statistically significant (log-rank test p=0.0039). The disease-free survival was 9 months in the sequential arm and 16 months in the concurrent treatment group. The differences were statistically significant (log-rank test p=0.0023). We found that the following prognostic factors significantly influenced the survival in lung cancer patients treated with conservative method: - age, p<0.05; - performant status, p<0.001; - weight loss, p<0.001; tumor dimension, p<0.05; and - nodal involvement, p<0.05.CONCLUSION:In our study, the dose-limiting toxicity, esophagitis was reduced by performing conformal radiotherapy. Conformal thoracic radiotherapy and new radiotherapy technics, such as respiratory gated radiotherapy, allow dose escalating and may probably improve survival and local control in lung cancer patients.

Prognostic factors for overall survival of stage III non-small cell lung cancer patients on computed tomography: A systematic review and meta-analysis

“…These studies yielded a total of 26 unique CT-related prognostic factors. Most studies had a retrospective cohort study design; nine studies reported a prospective cohort study design [14,20,[31][32][33][34][35][36][37]. In studies reporting follow-up duration, median follow-up ranged from 10 to 70.8 months.…”

“…Thirty inclusions explicitly stated using a clinical staging method [12,14,16,21,31,33,36,, while a combination of clinical and pathological staging was used in 3 studies [61][62][63]. The remaining 32 studies did not specify the staging method [11,13,15,17,18,20,32,34,35,37,. More recent staging systems TNM6 (2002, n = 9), TNM7 (2009, n = 23), and TNM8 (2017, n = 3) were used in 35 publications [11-13,15,16,33, 35,36,38,39,42,46,47,49,51,52,54-57,59,61-63,65,66,68,72,73,75,7 6,78,80,81,85].…”

Identifying Prognostic Groups Using Machine Learning Tools in Patients Undergoing Chemoradiation for Inoperable Locally Advanced Nonsmall Cell Lung Carcinoma

“…Age, gender, performance status, weight loss in the period of 3 months before diagnosis, baseline hemoglobin value, normal leukocytosis and normal neutrophil count, lactate dehydrogenase (LDH) level, hypercalcemia, hypoalbuminemia, tumor dimension, and involved lymph node burden are some of the known prognostic factors in NSCLC. 10,11 Prognostic classifications have been attempted based on gene signatures in resected specimen such as the 15-gene signatures, independent from stage with an overall HR of 15.02 (95% CI: 5.12-44.04) with consistent results in stages I and II. 12 However, till date, a correlation between the above mentioned and many other possibly unknown factors has not been established with varied survival outcomes for patients within a given stage.…”

In silico assessment of EpCAM transcriptional expression and determination of the prognostic biomarker for human lung adenocarcinoma (LUAD) and lung squamous cell carcinoma (LUSC)

“…Prognostic factors are meant to determine the features of patients and the stage of the cancer before the treatment is started. Some traditional prognostic factors for survival in patients with LUAD and LUSC are performance status, stage-tumor dimension, nodal status, and weight loss [ 35 ]. Moreover, symptoms are seen in advanced stages (stage III or stage IV) in about 70% of patients diagnosed with LC [ 36 ].…”