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Prognostic Factors in the Radical Nonsurgical Treatment of Stage IIIB Non–Small-Cell Lung Cancer
- Source :
- Clinical Lung Cancer. 15:237-243
- Publication Year :
- 2014
- Publisher :
- Elsevier BV, 2014.
-
Abstract
- Background Many patients diagnosed with stage IIIB (AJCC sixth edition; T4, N3, or both; no pleural effusion) non–small-cell lung cancer (NSCLC) are treated with curative intent, despite a low cure rate. Guidelines are required to help select patients for radical therapy so that the patients with little chance of cure may be spared the toxicities of aggressive treatment. A retrospective analysis was performed to investigate factors influencing outcomes in these patients. Materials and Methods From 2002 to 2009, all cases of stage IIIB NSCLC from the authors' institution were identified. Patients treated with radical radiotherapy (minimum dose, 50 Gy), with or without chemotherapy, were included. Charts were reviewed for patient demographic data, baseline blood work, tumor factors, treatment factors, and hospitalizations. The primary outcome was overall survival (OS), measured from time of diagnosis. Results Of 238 patients identified, 184 eligible cases were reviewed. The median follow-up for all patients was 17.2 months (range, 1.7-237.1). The median progression-free survival was 10.8 months (95% CI, 9.6-12.4). Median survival was 17.9 months, and OS was 68%, 42%, and 28% at 1, 2, and 3 years, respectively. In multivariate analysis, female gender (hazard ratio [HR], 0.58; 95% CI, 0.37-0.88; P = .0013), ≤ 5% weight loss (HR, 0.64; 95% CI, 0.43-0.93; P = .01), and absence of N3 disease (HR, 0.64; 95% CI, 0.42-0.96; P = .03) were associated with significantly longer survival. Conclusion OS was significantly longer in women, in patients with ≤ 5% weight loss, and in those without N3 disease. Good patient selection remains important in the radical treatment of stage IIIB NSCLC.
- Subjects :
- Adult
Male
Pulmonary and Respiratory Medicine
Cancer Research
medicine.medical_specialty
Lung Neoplasms
Multivariate analysis
Pleural effusion
medicine.medical_treatment
Antineoplastic Agents
Disease
Disease-Free Survival
Sex Factors
Weight loss
Carcinoma, Non-Small-Cell Lung
Internal medicine
medicine
Humans
Lung cancer
Aged
Neoplasm Staging
Retrospective Studies
Aged, 80 and over
Chemotherapy
business.industry
Patient Selection
Hazard ratio
Middle Aged
Prognosis
medicine.disease
Combined Modality Therapy
Surgery
Survival Rate
Radiation therapy
Oncology
Multivariate Analysis
Practice Guidelines as Topic
Female
medicine.symptom
business
Subjects
Details
- ISSN :
- 15257304
- Volume :
- 15
- Database :
- OpenAIRE
- Journal :
- Clinical Lung Cancer
- Accession number :
- edsair.doi.dedup.....4915ad7a300034201280fe38b0a658a8
- Full Text :
- https://doi.org/10.1016/j.cllc.2013.12.007