A retrospective study of clinicopathologic and molecular features of inoperable early-stage non-small cell lung cancer treated with stereotactic ablative radiotherapy

Background/Purpose: Stereotactic ablative radiotherapy (SABR) is the treatment of choice for medically inoperable, early-stage non-small cell lung cancer (ES-NSCLC). The influence of oncogenic driver alterations and comorbidities are not well known. Here we present treatment outcomes based on clinic...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	I-Han Lee, Guann-Yiing Chen, Chun-Ru Chien, Jason Chia-Hsien Cheng, Jenny Ling-Yu Chen, Wen-Chi Yang, Jin-Shing Chen, Feng-Ming Hsu
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Stereotactic ablative radiotherapy Non-small cell lung cancer Prognostic factor Oncogenic driver alteration Inoperable early-stage Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/8f093c41272a4b83bdc71725bb97894e
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:8f093c41272a4b83bdc71725bb97894e
record_format	dspace
spelling	oai:doaj.org-article:8f093c41272a4b83bdc71725bb97894e2021-12-02T04:59:09ZA retrospective study of clinicopathologic and molecular features of inoperable early-stage non-small cell lung cancer treated with stereotactic ablative radiotherapy0929-664610.1016/j.jfma.2020.12.028https://doaj.org/article/8f093c41272a4b83bdc71725bb97894e2021-12-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S0929664620306288https://doaj.org/toc/0929-6646Background/Purpose: Stereotactic ablative radiotherapy (SABR) is the treatment of choice for medically inoperable, early-stage non-small cell lung cancer (ES-NSCLC). The influence of oncogenic driver alterations and comorbidities are not well known. Here we present treatment outcomes based on clinicopathologic features and molecular profiles. Methods: We retrospectively analyzed patients treated with SABR for inoperable ES-NSCLC. Molecular features of oncogenic driver alterations included EGFR, ALK, and ROS1. Comorbidities were assessed using the age-adjusted Charlson Comorbidity Index (ACCI). Survival was calculated using the Kaplan–Meier method. The Cox regression model was performed for univariate and multivariate analyses of prognostic factors. Competing risk analysis was used to evaluate the cumulative incidence of disease progression. Results: From 2008 to 2020, 100 patients (median age: 82 years) were enrolled. The majority of patients were male (64%), ever-smokers (60%), and had adenocarcinoma (65%). With a median follow-up of 21.5 months, the median overall survival (OS) and real-world progression-free survival were 37.7 and 25.1 months, respectively. The competing-risk-adjusted 3-year cumulative incidences of local, regional, and disseminated failure were 8.2%, 14.5%, and 31.2%, respectively. An ACCI ≥7 was independently associated with inferior OS (hazard ratio [HR] 2.45, p = 0.03). Tumor size ≥4 cm (HR 4.16, p < 0.001) was the most important independent prognostic factor predicting real-world progression. EGFR mutation status had no impact on the outcomes. Conclusion: SABR provides excellent local control in ES-NSCLC, although disseminated failures remains a major concern. ACCI is the best indicator for OS, while tumor sizes ≥4 cm predicts poor disease control.I-Han LeeGuann-Yiing ChenChun-Ru ChienJason Chia-Hsien ChengJenny Ling-Yu ChenWen-Chi YangJin-Shing ChenFeng-Ming HsuElsevierarticleStereotactic ablative radiotherapyNon-small cell lung cancerPrognostic factorOncogenic driver alterationInoperable early-stageMedicine (General)R5-920ENJournal of the Formosan Medical Association, Vol 120, Iss 12, Pp 2176-2185 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Stereotactic ablative radiotherapy Non-small cell lung cancer Prognostic factor Oncogenic driver alteration Inoperable early-stage Medicine (General) R5-920
spellingShingle	Stereotactic ablative radiotherapy Non-small cell lung cancer Prognostic factor Oncogenic driver alteration Inoperable early-stage Medicine (General) R5-920 I-Han Lee Guann-Yiing Chen Chun-Ru Chien Jason Chia-Hsien Cheng Jenny Ling-Yu Chen Wen-Chi Yang Jin-Shing Chen Feng-Ming Hsu A retrospective study of clinicopathologic and molecular features of inoperable early-stage non-small cell lung cancer treated with stereotactic ablative radiotherapy
description	Background/Purpose: Stereotactic ablative radiotherapy (SABR) is the treatment of choice for medically inoperable, early-stage non-small cell lung cancer (ES-NSCLC). The influence of oncogenic driver alterations and comorbidities are not well known. Here we present treatment outcomes based on clinicopathologic features and molecular profiles. Methods: We retrospectively analyzed patients treated with SABR for inoperable ES-NSCLC. Molecular features of oncogenic driver alterations included EGFR, ALK, and ROS1. Comorbidities were assessed using the age-adjusted Charlson Comorbidity Index (ACCI). Survival was calculated using the Kaplan–Meier method. The Cox regression model was performed for univariate and multivariate analyses of prognostic factors. Competing risk analysis was used to evaluate the cumulative incidence of disease progression. Results: From 2008 to 2020, 100 patients (median age: 82 years) were enrolled. The majority of patients were male (64%), ever-smokers (60%), and had adenocarcinoma (65%). With a median follow-up of 21.5 months, the median overall survival (OS) and real-world progression-free survival were 37.7 and 25.1 months, respectively. The competing-risk-adjusted 3-year cumulative incidences of local, regional, and disseminated failure were 8.2%, 14.5%, and 31.2%, respectively. An ACCI ≥7 was independently associated with inferior OS (hazard ratio [HR] 2.45, p = 0.03). Tumor size ≥4 cm (HR 4.16, p < 0.001) was the most important independent prognostic factor predicting real-world progression. EGFR mutation status had no impact on the outcomes. Conclusion: SABR provides excellent local control in ES-NSCLC, although disseminated failures remains a major concern. ACCI is the best indicator for OS, while tumor sizes ≥4 cm predicts poor disease control.
format	article
author	I-Han Lee Guann-Yiing Chen Chun-Ru Chien Jason Chia-Hsien Cheng Jenny Ling-Yu Chen Wen-Chi Yang Jin-Shing Chen Feng-Ming Hsu
author_facet	I-Han Lee Guann-Yiing Chen Chun-Ru Chien Jason Chia-Hsien Cheng Jenny Ling-Yu Chen Wen-Chi Yang Jin-Shing Chen Feng-Ming Hsu
author_sort	I-Han Lee
title	A retrospective study of clinicopathologic and molecular features of inoperable early-stage non-small cell lung cancer treated with stereotactic ablative radiotherapy
title_short	A retrospective study of clinicopathologic and molecular features of inoperable early-stage non-small cell lung cancer treated with stereotactic ablative radiotherapy
title_full	A retrospective study of clinicopathologic and molecular features of inoperable early-stage non-small cell lung cancer treated with stereotactic ablative radiotherapy
title_fullStr	A retrospective study of clinicopathologic and molecular features of inoperable early-stage non-small cell lung cancer treated with stereotactic ablative radiotherapy
title_full_unstemmed	A retrospective study of clinicopathologic and molecular features of inoperable early-stage non-small cell lung cancer treated with stereotactic ablative radiotherapy
title_sort	retrospective study of clinicopathologic and molecular features of inoperable early-stage non-small cell lung cancer treated with stereotactic ablative radiotherapy
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/8f093c41272a4b83bdc71725bb97894e
work_keys_str_mv	AT ihanlee aretrospectivestudyofclinicopathologicandmolecularfeaturesofinoperableearlystagenonsmallcelllungcancertreatedwithstereotacticablativeradiotherapy AT guannyiingchen aretrospectivestudyofclinicopathologicandmolecularfeaturesofinoperableearlystagenonsmallcelllungcancertreatedwithstereotacticablativeradiotherapy AT chunruchien aretrospectivestudyofclinicopathologicandmolecularfeaturesofinoperableearlystagenonsmallcelllungcancertreatedwithstereotacticablativeradiotherapy AT jasonchiahsiencheng aretrospectivestudyofclinicopathologicandmolecularfeaturesofinoperableearlystagenonsmallcelllungcancertreatedwithstereotacticablativeradiotherapy AT jennylingyuchen aretrospectivestudyofclinicopathologicandmolecularfeaturesofinoperableearlystagenonsmallcelllungcancertreatedwithstereotacticablativeradiotherapy AT wenchiyang aretrospectivestudyofclinicopathologicandmolecularfeaturesofinoperableearlystagenonsmallcelllungcancertreatedwithstereotacticablativeradiotherapy AT jinshingchen aretrospectivestudyofclinicopathologicandmolecularfeaturesofinoperableearlystagenonsmallcelllungcancertreatedwithstereotacticablativeradiotherapy AT fengminghsu aretrospectivestudyofclinicopathologicandmolecularfeaturesofinoperableearlystagenonsmallcelllungcancertreatedwithstereotacticablativeradiotherapy AT ihanlee retrospectivestudyofclinicopathologicandmolecularfeaturesofinoperableearlystagenonsmallcelllungcancertreatedwithstereotacticablativeradiotherapy AT guannyiingchen retrospectivestudyofclinicopathologicandmolecularfeaturesofinoperableearlystagenonsmallcelllungcancertreatedwithstereotacticablativeradiotherapy AT chunruchien retrospectivestudyofclinicopathologicandmolecularfeaturesofinoperableearlystagenonsmallcelllungcancertreatedwithstereotacticablativeradiotherapy AT jasonchiahsiencheng retrospectivestudyofclinicopathologicandmolecularfeaturesofinoperableearlystagenonsmallcelllungcancertreatedwithstereotacticablativeradiotherapy AT jennylingyuchen retrospectivestudyofclinicopathologicandmolecularfeaturesofinoperableearlystagenonsmallcelllungcancertreatedwithstereotacticablativeradiotherapy AT wenchiyang retrospectivestudyofclinicopathologicandmolecularfeaturesofinoperableearlystagenonsmallcelllungcancertreatedwithstereotacticablativeradiotherapy AT jinshingchen retrospectivestudyofclinicopathologicandmolecularfeaturesofinoperableearlystagenonsmallcelllungcancertreatedwithstereotacticablativeradiotherapy AT fengminghsu retrospectivestudyofclinicopathologicandmolecularfeaturesofinoperableearlystagenonsmallcelllungcancertreatedwithstereotacticablativeradiotherapy
_version_	1718400901750718464

A retrospective study of clinicopathologic and molecular features of inoperable early-stage non-small cell lung cancer treated with stereotactic ablative radiotherapy

Ejemplares similares