Does Response to Induction Chemotherapy Predict Survival for Locally Advanced Non–Small-Cell Lung Cancer? Secondary Analysis of RTOG 8804/8808

McAleer, Mary Frances; Moughan, Jennifer; Byhardt, Roger W.; Cox, James D.; Sause, William T.; Komaki, Ritsuko

doi:10.1016/j.ijrobp.2009.02.053

Cited by 9 publications

(10 citation statements)

References 21 publications

(25 reference statements)

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“…Several investigators have demonstrated a significant association between the clinical tumor response and OS in patients with stage III NSCLC treated with CCRT (12)(13)(14). However, in the report by McAleer et al, Kaplan-Meier OS curves revealed that 90% of the responders died within 4 years (12), while the study by Kim et al used an insufficient follow-up (median follow-up: 16 months) (13).…”

Section: Discussionmentioning

confidence: 99%

“…Several researchers have investigated the predictive value of 18 F-fluorodeoxyglucose uptake on positron emission tomography, tumor volume, and clinical tumor response in patients with stage III NSCLC treated with CCRT (9)(10)(11)(12)(13)(14)(15). However, these studies were unable to clarify the predictive value of these factors because of various heterogeneities in the tumors and among patients with stage III NSCLC.…”

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confidence: 99%

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Prognostic Value of Serum Tumor Markers in Patients With Stage III NSCLC Treated With Chemoradiotherapy

Tokito

Azuma

Yamada

et al. 2019

In Vivo

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Background/Aim: Serum tumor markers such as carcinoembryonic antigen and cytokeratin subunit 19 fragment are generally monitored in non-small cell lung cancer (NSCLC) patients in the clinical practice. However, their clinical relevance in stage III NSCLC treated with concurrent chemoradiotherapy (CCRT) remains unclear. Herein, we examined the clinical relevance of tumor markers in those patients. Patients and Methods: We retrospectively reviewed 62 consecutive patients with stage III NSCLC who received CCRT. We examined the associations of tumor marker levels with their prognosis. Results: There was no correlation between pretreatment tumor marker levels and prognosis. Normal tumor marker levels post-CCRT were significantly associated with favorable progression-free survival (54.8 versus 14.5 months, p=0.02) and overall survival (71.7 versus 40.4 months, p=0.06) compared with high tumor marker levels post-CCRT. Conclusion: We revealed that normal tumor markers levels post-CCRT in stage III NSCLC might be a useful surrogate marker for curing those patients. Lung cancer is the leading cause of cancer-related death worldwide (1). Non-small cell lung cancer (NSCLC) accounts for 80% of all lung cancer cases and approximately 30% of NSCLC patients present with stage III disease (2-3). Concurrent chemoradiotherapy (CCRT) is the standard of care for these patients (4-5). Despite extensive research into 889 This article is freely accessible online.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Prognostic Value of Serum Tumor Markers in Patients With Stage III NSCLC Treated With Chemoradiotherapy

Tokito

Azuma

Yamada

et al. 2019

In Vivo

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“…Several volumetric studies have been conducted to evaluate initial GTV as a prognostic factor in patients with NSCLC who underwent definitive RT [ 6 - 12 ]. However, the prognostic role of residual tumor volume or tumor response after treatment was assessed only in trials of induction therapy for NSCLC [ 8 , 17 , 18 ], not definitive CCRT. To our knowledge, the present study is the first to evaluate the prognostic role of volumetric parameters and include GTV pre , GTV post , and VRR in patients with NSCLC who underwent definitive CCRT.…”

Section: Discussionmentioning

confidence: 99%

The effect of tumor volume and its change on survival in stage III non-small cell lung cancer treated with definitive concurrent chemoradiotherapy

et al. 2014

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BackgroundTo investigate a prognostic role of gross tumor volume (GTV) changes on survival outcomes following concurrent chemoradiotherapy (CCRT) in stage III non-small-cell lung cancer (NSCLC) patients.MethodsWe enrolled 191 patients with stage III NSCLC from 2001 to 2009 undergoing definitive CCRT. The GTV of 157 patients was delineated at the planning CT prior to CCRT and with a follow-up CT 1 month after CCRT. We assessed the volumetric parameters of pre-treatment GTV (GTVpre) post-treatment GTV (GTVpost), and volume reduction ratio of GTV (VRR). The primary endpoint was overall survival (OS) and secondary endpoints were progression-free survival (PFS) and locoregional progression-free survival (LRPFS). The best cut-off value was defined as that which exhibited the maximum difference between the two groups.ResultsThe median follow-up duration was 52.7 months in surviving patients. Median survival, 3-year OS, PFS and LRPFS rates were 25.5 months, 36.4%, 23.0%, and 45.0%, respectively. The selected cut-off values were 50 cm3 for GTVpre, 20 cm3 for GTVpost, and 50% for VRR. The smaller GTVpre and GTVpost values were associated with better OS (p < 0.001 and p = 0.015) and PFS (p = 0.001 and p = 0.004), respectively, upon univariate analysis. The higher VRR of > 50% was associated with a trend toward poorer OS (p = 0.004) and PFS (p = 0.054). Upon multivariate analysis, smaller GTVpre indicated significantly improved OS (p = 0.001), PFS (p = 0.013) and LRPFS (p = 0.002), while smaller GTVpost was marginally significant for PFS (p = 0.086). Higher VRR was associated with a trend toward poorer OS (p = 0.075).ConclusionsIn patients with stage III NSCLC undergoing definitive CCRT, GTVpre was an independent prognostic factor of survival. Notably, improved outcome was not correlated with higher VRR after short-term follow-up with CT alone.Electronic supplementary materialThe online version of this article (doi:10.1186/s13014-014-0283-6) contains supplementary material, which is available to authorized users.

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“…McAleer et al, did a combined analysis of two RTOG studies with CRT [13]. They reported that response to induction chemotherapy was a possible predictor of long survival (p = 0.06).…”

Section: Discussionmentioning

confidence: 99%

Progression-free survival at 2 years is a reliable surrogate marker for the 5-year survival rate in patients with locally advanced non-small cell lung cancer treated with chemoradiotherapy

et al. 2014

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BackgroundIn locally advanced Non-Small-Cell Lung Cancer (LA-NSCLC) patients treated with chemoradiotherapy (CRT), optimal surrogate endpoint for cure has not been fully investigated.MethodsThe clinical records of LA-NSCLC patients treated with concurrent CRT at Shizuoka Cancer Center between Sep. 2002 and Dec. 2009 were reviewed. The primary outcome of this study was to evaluate the surrogacy of overall response rate (ORR) and progression-free survival (PFS) rate at 3-month intervals (from 9 to 30 months after the initiation of treatment) for the 5-year survival rate. Landmark analyses were performed to assess the association of these outcomes with the 5-year survival rate.ResultsOne hundred and fifty-nine patients were eligible for this study. The median follow-up time for censored patients was 57 months. The ORR was 72%, median PFS was 12 months, and median survival time was 39 months.Kaplan-Meier curve of progression-free survival and hazard ratio of landmark analysis at each time point suggest that most progression occurred within 2 years. With regard to 5-year survival rate, patients with complete response, or partial response had a rate of 45%. Five-year survival rates of patients who were progression free at each time point (3-months intervals from 9 to 30 months) were 53%, 69%, 75%, 82%, 84%, 89%, 90%, and 90%, respectively. The rate gradually increased in accordance with progression-free interval extended, and finally reached a plateau at 24 months.ConclusionsProgression-free survival at 2 years could be a reliable surrogate marker for the 5-year survival rate in LA-NSCLC patients treated with concurrent CRT.

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Does Response to Induction Chemotherapy Predict Survival for Locally Advanced Non–Small-Cell Lung Cancer? Secondary Analysis of RTOG 8804/8808

Cited by 9 publications

References 21 publications

Prognostic Value of Serum Tumor Markers in Patients With Stage III NSCLC Treated With Chemoradiotherapy

Prognostic Value of Serum Tumor Markers in Patients With Stage III NSCLC Treated With Chemoradiotherapy

The effect of tumor volume and its change on survival in stage III non-small cell lung cancer treated with definitive concurrent chemoradiotherapy

Progression-free survival at 2 years is a reliable surrogate marker for the 5-year survival rate in patients with locally advanced non-small cell lung cancer treated with chemoradiotherapy

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