The Addition of Chemotherapy to Radiation Therapy Improves Survival in Elderly Patients with Stage III Non–Small Cell Lung Cancer

Miller, Eric D.; Fisher, James L.; Haglund, K.E.; Grecula, J.C.; Xu‐Welliver, Meng; Bertino, Erin M.; He, Kai; Shields, Peter G.; Carbone, David P.; Williams, Terence M.; Otterson, Gregory A.; Bazan, Jose G.

doi:10.1016/j.jtho.2017.11.135

Cited by 66 publications

(63 citation statements)

References 27 publications

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“…The OS results from this study are in-line with a published meta-analysis [22] and other recent population-based studies of patients diagnosed with unresected stage III NSCLC who received cCRT (median OS 13 to 18 months) [23][24][25], but are shorter than results for the standard radiation dose arm (29 months) in the recently completed Radiation Therapy Oncology Group (RTOG) clinical trial that evaluated optimal cCRT regimens (RTOG 0617) [26]. The current study did not assess radiation dose, and included patients not treated with radiation, or treated with radiation therapy only, all of which may explain discrepancies in findings between our study and RTOG 0617.…”

Section: Discussionsupporting

confidence: 87%

Real-world outcomes in patients with unresected stage III non-small cell lung cancer

et al. 2019

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This study examined real-world clinical outcomes such as progression-free survival (PFS), time to metastasis (TTM), overall survival (OS), and health-related quality of life (HRQOL) in patients with unresected stage III non-small cell lung cancer (NSCLC) treated in the community setting. A retrospective review of medical records extracted from 10 US community oncology practices was conducted. Eligible patients were adults diagnosed with stage III NSCLC from 1/1/2011 to 3/1/2016 without evidence of surgical resection within 6 months after stage III NSCLC diagnosis (index date). PFS, OS, and TTM were assessed from the index date, and were analyzed using Kaplan-Meier and Cox regression analyses. HRQOL was assessed for a subset of patients using a patient-reported measure, the 86-item Patient Care Monitor (PCM). Linear mixed models (LMM) were used to assess the impact of patient characteristics and change in PCM scores associated with progression. Among the sample of 478 patients, median PFS (95% confidence interval) was 10 months (9-11), median OS was 20 months (17-22), and median TTM was 30 months (23-45). Most patients (58.2%) experienced disease progression, which the LMM showed to be associated with significant worsening of physical symptoms and psychological states (p < 0.001). This study documented PFS and OS consistent with published literature. The majority of patients experienced disease progression, which was associated with worsening of HRQOL. These findings highlighted the need for better therapeutic options in patients with unresected stage III NSCLC with potential to improve patient outcomes and HRQOL.

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Section: Discussionsupporting

confidence: 87%

Real-world outcomes in patients with unresected stage III non-small cell lung cancer

et al. 2019

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“…Treatment with chemoradiation was associated with improved OS versus that with radiation [hazard ratio (HR) = 0.66, 95% confidence interval (CI): 0.64-0.68, p <0.001]. Strikingly, when related to the concurrent chemoradiation, the sequential chemoradiation was associated with a 9% reduction in the risk for death (HR = 0.91, 95% CI: 0.85-0.96, p = 0.002) (31).…”

Section: Chemoradiotherapymentioning

confidence: 99%

Undertreatment or overtreatment – how far from each other in geriatric oncology?

Kocik

2020

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The mortality due to cancers of older patients, in age above 65 years of life, in comparison to younger is higher in majority of these diseases. It has been also reported that seniors are frequently denied the treatment according to current standards of therapy, thus suffer from undertreatment. There is solid evidence from controlled trials that older patients may tolerate pharmacological therapies in some cancers as well as young, providing they are under good supportive care. At the same time aggressive multimodal treatment may cause immediate or delayed side effects and exhaustion of reserves of the vital organs in elderly. This may cause a general deterioration, a decompensation of comorbidities, an evolution of geriatric syndromes and premature death, not directly caused by cancer. Such situation in aged cancer patients should be called the overtreatment. In diseases with better prognosis, with effective screening methods and large choice of treatment options like breast cancer, survival is getting better, although not in the eldest. The worse prognosis in old breast cancer patients may be caused to some extent by undertreatment. More fatal tumors like NSCLC await further optimization of cancer therapy towards better toxicity profile to avoid overtreatment.

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“…1 Investigations indicate that the addition of chemotherapy to RT improves the efficiency of treatment in cancer patients. 2 There are serious efforts to improve and develop RT efficacy. 3 It is reported that the inhibition of certain signaling pathways is associated with the enhancement of RT response in several cancer types.…”

Section: Introductionmentioning

confidence: 99%

Assessment of the SRC Inhibition Role in the Efficacy of Breast Cancer Radiotherapy

2019

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Introduction: Radiotherapy (RT) is an effective therapeutic method for preventing the recurrence of breast cancer after surgery. The development and improvement of RT are of interest to scientists. Possible improvement of RT via study of dysregulated proteins of breast cancer cell line MDA-MB-231 which is exposed to 10 Gray (Gy) radiation is aim of this study. Methods: Using protein-protein interaction (PPI) network analysis by means of running Cytoscape software via the STRING database, the up-regulated proteins of MDA-MB-231 breast cancer cells irradiated by a single and fractioned 10 Gy 137Cs γ-radiation were analyzed. The network was analyzed by using the Network analyzer to characterize the central genes. The action map was mapped for the queried genes and the added neighbors via CluePedia-STRING ACTIONS-v10.5- 20.11.2017. Results: The 14 differentially expressed proteins (DEPs) plus 10 neighbors interacted to construct a network. Among the 14 queried DEPs, FN1, CSPG4, LRP1, GSN, RTN4, and CTSD were highlighted as a complex set in the analysis. The analysis revealed that SRC as an added neighbor was activated by the critical DEPs. The activation of other oncogenes like AKT1 was also determined. Conclusion: The results indicate that the inhibition of SRC activity or the inhibition of its activators is a useful function of breast cancer RT

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The Addition of Chemotherapy to Radiation Therapy Improves Survival in Elderly Patients with Stage III Non–Small Cell Lung Cancer

Cited by 66 publications

References 27 publications

Real-world outcomes in patients with unresected stage III non-small cell lung cancer

Real-world outcomes in patients with unresected stage III non-small cell lung cancer

Undertreatment or overtreatment – how far from each other in geriatric oncology?

Assessment of the SRC Inhibition Role in the Efficacy of Breast Cancer Radiotherapy

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