Patterns of relapse of clinical N2 non-small-cell lung cancer (NSCLC) treated with preoperative chemotherapy: Should propylactic cranial irradiation be reconsidered?

André, Fabrice; Grunenwald, Dominique; Pignon, J.P.; Pujol, Jean Louis; Brichon, Pierre Yves; Brouchet, L.; Dujon, Antoine; Weestel, V.; Chevalier, Thierry Le

doi:10.1016/s0169-5002(00)80311-6

Cited by 18 publications

(34 citation statements)

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“…The results showed the OS, DFS, MS in the whole group of patients, in the BM group, and in the non-BM group were all in accordance with the reported results (3)(4)(5)(6)(7)33,34). For patients who developed BM, the incidence of BM, the time of BM, and the survival after BM also agreed with the reported results (1,6,(35)(36)(37). All these data proved the eligible patients in our study were clinically representative.…”

Section: Discussionsupporting

confidence: 91%

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The predictive value and potential mechanisms of miRNA-328 and miRNA-378 for brain metastases in operable and advanced non-small-cell lung cancer

Sun

et al. 2015

Japanese Journal of Clinical Oncology

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Objective: The incidence of brain metastases greatly varies in patients with non-small-cell lung cancer, and molecular markers are considered to predict brain metastases. Therefore, this study sought to identify the predictive value and potential mechanisms of miRNA-328 and miRNA-378 for brain metastases in non-small-cell lung cancer. Methods: Patients who received a curable surgery for their lung cancer were screened according to our criteria. Formalin-fixed paraffin-embedded samples from the patients were examined for the expression of miRNA-328 and miRNA-378 using real-time polymerase chain reaction and the expression of N-cadherin, E-cadherin, vascular endothelial growth factor, protein kinase Cα and S100B were investigated using immunohistochemical staining. Results: In total, 86 patients were screened for this study and 23 patients were diagnosed with brain metastases during the follow-up period. Comparing patients with and without brain metastases, the expression of miRNA-328 and miRNA-378 in tumor tissues were significantly different (P = 6.2 × 10 −5 and P = 2.8 × 10 −5 , respectively). For the patients with brain metastases, the expression of miRNA-328and miRNA-378 in tumor tissues compared with para-carcinoma tissues were also significantly different (P = 2.2 × 10 −5 and P = 1.6 × 10 −5 , respectively). For patients with brain metastases, the association between miRNA-328 and protein kinase Cα was significant (r = 0.591, P = 0.003), but that between miRNA-378 and protein kinase Cα was not significant (r = 0.259, P = 0.232). Conclusions:The expression of miRNA-328 and miRNA-378 in tumor tissues can be used to predict brain metastases in patients with non-small-cell lung cancer. miRNA-328 might promote brain metastases by regulating the expression of protein kinase Cα. However, the mechanisms of miRNA-378 to promote brain metastases should be studied in the future.

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Section: Discussionsupporting

confidence: 91%

“…The incidence of BM is reported in ∼50% of patients with small-cell lung cancer (SCLC) and in ∼25% of patients with non-small-cell lung cancer (NSCLC) (1,2). In addition, the incidence of BM is higher with increased overall survival (OS) (3)(4)(5)(6)(7).…”

Section: Introductionmentioning

confidence: 99%

The predictive value and potential mechanisms of miRNA-328 and miRNA-378 for brain metastases in operable and advanced non-small-cell lung cancer

Sun

et al. 2015

Japanese Journal of Clinical Oncology

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“…Approximately, 40% of patients with stage IIIA NSCLC treated with preoperative chemotherapy and surgical resection have been reported to develop brain metastases (Andre et al, 2001;Mamon et al, 2005). The risk of developing brain metastases appears to be associated with nonsquamous histology (Robnett et al, 2001;Mamon et al, 2005) and with the type of chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

Prognostic factors affecting long-term outcomes in patients with resected stage IIIA pN2 non-small-cell lung cancer: 5-year follow-up of a phase II study

et al. 2006

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The aim was to investigate the efficacy of neoadjuvant docetaxel -cisplatin and identify prognostic factors for outcome in locally advanced stage IIIA (pN2 by mediastinoscopy) non-small-cell lung cancer (NSCLC) patients. In all, 75 patients (from 90 enrolled) underwent tumour resection after three 3-week cycles of docetaxel 85 mg m À2 (day 1) plus cisplatin 40 or 50 mg m À2 (days 1 and 2). Therapy was well tolerated (overall grade 3 toxicity occurred in 48% patients; no grade 4 nonhaematological toxicity was reported), with no observed late toxicities. Median overall survival (OS) and event-free survival (EFS) times were 35 and 15 months, respectively, in the 75 patients who underwent surgery; corresponding figures for all 90 patients enrolled were 28 and 12 months. At 3 years after initiating trial therapy, 27 out of 75 patients (36%) were alive and tumour free. At 5-year follow-up, 60 and 65% of patients had local relapse and distant metastases, respectively. The most common sites of distant metastases were the lung (24%) and brain (17%). Factors associated with OS, EFS and risk of local relapse and distant metastases were complete tumour resection and chemotherapy activity (clinical response, pathologic response, mediastinal downstaging). Neoadjuvant docetaxel -cisplatin was effective and tolerable in stage IIIA pN2 NSCLC, with chemotherapy contributing significantly to outcomes.

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“…BM frequently occurs in patients with NSCLC, but the incidence of BM varies (Albain et al, 1995;Andre et al, 2001;Chen et al, 2007) as a function of the heterogeneity between NSCLC patients. A number of clinicopathologic characteristics are regarded to be associated with the incidence of BM, and many scholars have conducted research on this issue within the last 30 years, but to date, we have not identified which clinicopathologic characteristics influence the development of BM.…”

Section: Discussionmentioning

confidence: 99%

“…The central nervous system (CNS) is a frequent site for metastasis in patients with NSCLC. The reported incidence of brain metastases (BM) in patients with NSCLC is 21-54% (Albain et al, 1995;Andre et al, 2001;Chen et al, 2007), and the incidence of BM will be higher as the overall survival (OS) increases.…”

Section: Introductionmentioning

confidence: 99%

A Systematic Review of Risk Factors for Brain Metastases and Value of Prophylactic Cranial Irradiation in Non-Small Cell Lung Cancer

Sun¹,

Hu²,

Cai³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Background: The incidence of brain metastases (BM) varies in patients with non-small cell lung cancer (NSCLC), calls into question the value of prophylactic cranial irradiation (PCI). It is possible that clinicopathologic characteristics are associated with the development of BM, but these have yet to be identified in detail. Thus, we conducted the present meta-analysis on risk factors for BM and the value of PCI in patients with NSCLC. Methods: Eligible data were extracted and the risk factors for BM and the value of PCI in patients with NSCLC were analyzed by calculating the pooled odds ratio (OR). Heterogeneity was detected using Q and I-squared statistics, and publication bias was tested by funnel plots and Egger's test. Results: Six randomized controlled trials with a focus on the value of PCI and 13 eligible studies with a focus on risk factors for BM were included. PCI significantly reduced the incidence of BM in patients with NSCLC (p=0.000, pooled OR=0.34, 95% confidence interval = 0.37-0.59). Compared with non-squamous cell carcinoma, squamous cell carcinoma was associated with a low incidence of BM in patients with NSCLC (p=0.000, pooled OR=0.47, 95% confidence interval =0.34-0.65). The funnel plot and Egger's test suggested that there was no publication bias in the current meta-analysis. Conclusions: This meta-analysis provides statistical evidence that compared with non-squamous cell carcinoma, squamous cell carcinoma can be used as a predictor for BM in patients with NSCLC, and PCI might reduce the incidence of BM in patients with NSCLC, but does not provide a survival benefit.

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Patterns of relapse of clinical N2 non-small-cell lung cancer (NSCLC) treated with preoperative chemotherapy: Should propylactic cranial irradiation be reconsidered?

Cited by 18 publications

References 0 publications

The predictive value and potential mechanisms of miRNA-328 and miRNA-378 for brain metastases in operable and advanced non-small-cell lung cancer

The predictive value and potential mechanisms of miRNA-328 and miRNA-378 for brain metastases in operable and advanced non-small-cell lung cancer

Prognostic factors affecting long-term outcomes in patients with resected stage IIIA pN2 non-small-cell lung cancer: 5-year follow-up of a phase II study

A Systematic Review of Risk Factors for Brain Metastases and Value of Prophylactic Cranial Irradiation in Non-Small Cell Lung Cancer

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