• Int. J. Radiat. Oncol. Biol. Phys. · Nov 2011

    Weight gain in advanced non-small-cell lung cancer patients during treatment with split-course concurrent chemoradiotherapy is associated with superior survival.

    • Benjamin T Gielda, Par Mehta, Atif Khan, James C Marsh, Thomas W Zusag, William H Warren, Mary Jo Fidler, Ross A Abrams, Philip Bonomi, Michael Liptay, and L Penfield Faber.
    • Department of Radiation Oncology, Rush University Medical Center, Chicago, IL 60612, USA. Benjamin_gielda@rush.edu
    • Int. J. Radiat. Oncol. Biol. Phys. 2011 Nov 15; 81 (4): 985-91.

    BackgroundPreoperative concurrent chemoradiotherapy (CRT) is an accepted treatment for potentially resectable, locally advanced, non-small-cell lung cancer (NSCLC). We reviewed a decade of single institution experience with preoperative split-course CRT followed by surgical resection to evaluate survival and identify factors that may be helpful in predicting outcome.Methods And MaterialsAll patients treated with preoperative split-course CRT and resection at Rush University Medical Center (RUMC) between January 1999 and December 2008 were retrospectively analyzed. Endpoints included overall survival (OS), progression-free survival (PFS), local-regional progression-free survival (LRPFS), and distant metastasis-free survival (DMFS). Patient and treatment related variables were assessed for correlation with outcomes.ResultsA total of 54 patients were analyzed, 76% Stage IIIA, 18% Stage IIIB, and 6% oligometastatic. The pathologic complete response (pCR) rate was 31.5%, and the absence of nodal metastases (pN0) was 64.8%. Median OS and 3-year actuarial survival were 44.6 months and 50%, respectively. Univariate analysis revealed initial stage (p < 0.01) and percent weight change during CRT (p < 0.01) significantly correlated with PFS/OS. On multivariate analysis initial stage (HR, 2.4; 95% CI, 1.18-4.90; p = 0.02) and percent weight change (HR, 0.79; 95% CI, 0.67-0.93; p < 0.01) maintained significance with respect to OS. There were no cases of Grade 3+ esophagitis, and there was a single case of Grade 3 febrile neutropenia.ConclusionsThe strong correlation between weight change during CRT and OS/PFS suggests that this clinical parameter may be useful as a complementary source of predictive information in addition to accepted factors such as pathological response.Copyright © 2011 Elsevier Inc. All rights reserved.

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