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Prognostic factors identified for locally advanced NSCLC
Jeremic B. Cancer. 2011;doi:10.1002/cncr.25910.
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Prognostic factors have been indentified in patients with stage III non–small cell lung cancer who were treated with hyperfractionated radiation therapy with or without chemotherapy, according to a study.
Researchers from the University Hospital in Kragujevac, Serbia, reviewed three phase 3 and two phase 2 studies in which 600 patients were treated. Hyperfractionated radiation therapy was given alone to 127 patients, and hyperfractionated radiation therapy with concurrent chemotherapy was given to the remaining 473 patients.
The patients received either 1.2 Gy twice-daily of hyperfractionated radiation therapy with a total dose of 64.8 Gy or 69.6 Gy, or they received 1.3 Gy twice-daily with a total dose of 67.6 Gy. For those who received chemotherapy, 409 received concurrent carboplatin and etoposide while 64 received concurrent carboplatin and paclitaxel.
Sex, age, Karnofsky performance score, weight loss, stage, histology, interfraction interval and the addition of chemotherapy were investigated as possible prognostic factors.
The median OS was 19 months, the median local PFS was 21 months and the median distant metastasis-free survival was 23 months. Five-year OS was 19%, 5-year local PFS was 29% and 5-year distant metastasis-free survival was 35%.
On univariate and multivariate analysis, only age failed to influence the OS and the local PFS. Female sex, lower Karnofsky performance score, less weight loss, lower stage, squamous histology, shorter interfraction interval and addition of chemotherapy predicted better OS and local PFS. Age and addition of chemotherapy did not influence distant metastasis-free survival.
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