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International Journal of Clinical Oncology

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28.04.2016 | Original Article

Impact of early tumor reduction on outcome differs by histological subtype in stage III non-small-cell lung cancer treated with definitive radiotherapy

verfasst von: Hiromitsu Kanzaki, Masaaki Kataoka, Atsushi Nishikawa, Kotaro Uwatsu, Kei Nagasaki, Noriko Nishijima, Takashi Ochi, Teruhito Mochizuki

Erschienen in: International Journal of Clinical Oncology | Ausgabe 5/2016

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Abstract

Background

We retrospectively investigated the impact on survival of early tumor reduction during definitive radiotherapy for inoperable stage III non-small cell lung cancer (NSCLC) patients, according to their histological subtypes.

Methods

Between November 2006 and December 2012, 152 consecutive patients with inoperable stage III NSCLC who underwent definitive radiotherapy were reviewed retrospectively. Forty-one patients were excluded for not satisfying the inclusion criteria. Forty-five (40.5 %) and 48 (43.2 %) patients were diagnosed with squamous cell carcinoma (SQC) and adenocarcinoma (ADC), respectively. The tumor reduction rate (TRR) was defined as follows: TRR = 1−[gross tumor volume (GTV) on computed tomography at shrinking irradiation field planning]/(GTV on computed tomography at the initial treatment planning). The Cox proportional hazard model was used to identify significant prognostic factors for overall survival (OS) and progression-free survival (PFS).

Results

We evaluated 111 patients, with a median follow-up time of 52.2 months in surviving patients. The median TRR was 45.9 %. In all patients, there were significant associations between TRR and PFS (P = 0.036) on multivariate analysis, although TRR had no correlation with OS (P = 0.141). With respect to histological subtype, multivariate analyses revealed that a higher TRR showed significant associations with better OS and PFS in the SQC group (P = 0.013 and 0.040, respectively). In contrast, a higher TRR was associated with poorer OS in the ADC group (P = 0.030); there was no association between TRR and PFS.

Conclusion

We found that a higher TRR is a promising prognostic factor for better survival and disease control in SQC patients.

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Titel: Impact of early tumor reduction on outcome differs by histological subtype in stage III non-small-cell lung cancer treated with definitive radiotherapy
verfasst von: Hiromitsu Kanzaki
Masaaki Kataoka
Atsushi Nishikawa
Kotaro Uwatsu
Kei Nagasaki
Noriko Nishijima
Takashi Ochi
Teruhito Mochizuki
Publikationsdatum: 28.04.2016
Verlag: Springer Japan
Erschienen in: International Journal of Clinical Oncology / Ausgabe 5/2016
Print ISSN: 1341-9625
Elektronische ISSN: 1437-7772
DOI: https://doi.org/10.1007/s10147-016-0982-0

Springer Medizin

Impact of early tumor reduction on outcome differs by histological subtype in stage III non-small-cell lung cancer treated with definitive radiotherapy