Outcomes of concurrent chemoradiotherapy in patients with stage III non-small-cell lung cancer and significant comorbidity
Background: Published trials of concurrent chemoradiotherapy (CCRT) in stage III non-small-cell lung cancer (NSCLC) generally excluded patients with significant comorbidity. We evaluated outcomes in patients who were selected by using radiation planning parameters and were considered, despite comorb...
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| Veröffentlicht in: | Annals of oncology 2011-01, Vol.22 (1), p.132-138 |
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| creator | Phernambucq, E.C.J. Spoelstra, F.O.B. Verbakel, W.F.A.R. Postmus, P.E. Melissant, C.F. Maassen van den Brink, K.I. Frings, V. van de Ven, P.M. Smit, E.F. Senan, S. |
| description | Background: Published trials of concurrent chemoradiotherapy (CCRT) in stage III non-small-cell lung cancer (NSCLC) generally excluded patients with significant comorbidity. We evaluated outcomes in patients who were selected by using radiation planning parameters and were considered, despite comorbidity, fit enough to receive cisplatin-based chemotherapy.
Patients and methods: From 2003 to 2008, 89 patients with stage III NSCLC fit to receive cisplatin-based chemotherapy and a V20 |
| doi_str_mv | 10.1093/annonc/mdq316 |
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| fullrecord | <record><control><sourceid>pubmed_cross</sourceid><recordid>TN_cdi_crossref_primary_10_1093_annonc_mdq316</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0923753419377798</els_id><sourcerecordid>20595452</sourcerecordid><originalsourceid>FETCH-LOGICAL-c409t-46a0c4a2a5c9755dbc267886f4f5fdc52fc004639347dda2d9d863214eaa44923</originalsourceid><addsrcrecordid>eNp1kDFv2zAQRokiRe24HbMGXDIqpiiSMsfCSFoDAbyks3A-kjYLiXJIuoHz68tCTjt1OuDu4cN3j5Cbmt3XTDdLCGEMuBzMS1OrD2ReS6WrFRP1FZkzzZuqlY2YkeuUfjLGlOb6E5lxJrUUks_J2_aUcRxsoqOjWJJOMdqQKR7sMEYwfswHG-F4pj7QI2Rfjom--nygKcPe0s1mQ0uDKg3Q9xXavqf9KewpQkAbKQRDk98H73zZlNyxxO688fn8mXx00Cf75TIX5Mfjw_P6e_W0_bZZf32qUDCdK6GAoQAOEnUrpdkhV-1qpZxw0hmU3CFjQjW6Ea0xwI02K9XwWlgAIYqBBammXIxjStG67hj9APHc1az747CbHHaTw8LfTvzxtBus-Uu_SyvA3QWAhNC7WF716R8nmCoNWeHaibPlu1_exi5h8YfW-Ggxd2b0_6nwG8Zrkoc</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>Outcomes of concurrent chemoradiotherapy in patients with stage III non-small-cell lung cancer and significant comorbidity</title><source>MEDLINE</source><source>EZB-FREE-00999 freely available EZB journals</source><source>Alma/SFX Local Collection</source><creator>Phernambucq, E.C.J. ; Spoelstra, F.O.B. ; Verbakel, W.F.A.R. ; Postmus, P.E. ; Melissant, C.F. ; Maassen van den Brink, K.I. ; Frings, V. ; van de Ven, P.M. ; Smit, E.F. ; Senan, S.</creator><creatorcontrib>Phernambucq, E.C.J. ; Spoelstra, F.O.B. ; Verbakel, W.F.A.R. ; Postmus, P.E. ; Melissant, C.F. ; Maassen van den Brink, K.I. ; Frings, V. ; van de Ven, P.M. ; Smit, E.F. ; Senan, S.</creatorcontrib><description>Background: Published trials of concurrent chemoradiotherapy (CCRT) in stage III non-small-cell lung cancer (NSCLC) generally excluded patients with significant comorbidity. We evaluated outcomes in patients who were selected by using radiation planning parameters and were considered, despite comorbidity, fit enough to receive cisplatin-based chemotherapy.
Patients and methods: From 2003 to 2008, 89 patients with stage III NSCLC fit to receive cisplatin-based chemotherapy and a V20 <42% underwent CCRT at one center outside clinical trials. Most received one cycle of cisplatin–gemcitabine, followed by two to three cycles of cisplatin–etoposide concurrent with involved-field thoracic radiotherapy between 46 and 66Gy.
Results: Median age was 64 years; performance status (PS) of zero, one or two in 20/64/5 patients; one or more comorbidities in 41.6%; 14% were treated previously for NSCLC. Median V20 was 26.6% (range 4%–39.4%). Grade III esophagitis and pneumonitis occurred in 28.1% and 7.9% of patients, respectively, while 4.5% died during treatment. Median overall survival was 18.2 months [95% confidence interval (CI) 13.1–23.3 months]. Independent prognostic factors for overall survival were PS (0 versus ≥1, P = 0.041) and planning target volume (P = 0.022).
Conclusions: Patients with significant comorbidity who are fit to undergo cisplatin-based CCRT achieve median survivals similar to that reported in phase III trials and with relatively few late toxic effects.</description><identifier>ISSN: 0923-7534</identifier><identifier>EISSN: 1569-8041</identifier><identifier>DOI: 10.1093/annonc/mdq316</identifier><identifier>PMID: 20595452</identifier><language>eng</language><publisher>Oxford: Elsevier Ltd</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Antineoplastic agents ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Biological and medical sciences ; Carcinoma, Non-Small-Cell Lung - drug therapy ; Carcinoma, Non-Small-Cell Lung - radiotherapy ; Charlson comorbidity index ; Cisplatin - administration & dosage ; Combined Modality Therapy ; Comorbidity ; concurrent chemoradiotherapy ; Deoxycytidine - administration & dosage ; Deoxycytidine - analogs & derivatives ; Etoposide - administration & dosage ; Female ; Humans ; Lung Neoplasms - drug therapy ; Lung Neoplasms - radiotherapy ; Male ; Medical sciences ; Middle Aged ; Neoplasm Staging ; patient selection ; Pharmacology. Drug treatments ; Pneumology ; stage III NSCLC ; Survival Rate ; toxicity ; Treatment Outcome ; Tumors of the respiratory system and mediastinum</subject><ispartof>Annals of oncology, 2011-01, Vol.22 (1), p.132-138</ispartof><rights>2010 European Society for Medical Oncology</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c409t-46a0c4a2a5c9755dbc267886f4f5fdc52fc004639347dda2d9d863214eaa44923</citedby><cites>FETCH-LOGICAL-c409t-46a0c4a2a5c9755dbc267886f4f5fdc52fc004639347dda2d9d863214eaa44923</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,4024,27923,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24066780$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20595452$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Phernambucq, E.C.J.</creatorcontrib><creatorcontrib>Spoelstra, F.O.B.</creatorcontrib><creatorcontrib>Verbakel, W.F.A.R.</creatorcontrib><creatorcontrib>Postmus, P.E.</creatorcontrib><creatorcontrib>Melissant, C.F.</creatorcontrib><creatorcontrib>Maassen van den Brink, K.I.</creatorcontrib><creatorcontrib>Frings, V.</creatorcontrib><creatorcontrib>van de Ven, P.M.</creatorcontrib><creatorcontrib>Smit, E.F.</creatorcontrib><creatorcontrib>Senan, S.</creatorcontrib><title>Outcomes of concurrent chemoradiotherapy in patients with stage III non-small-cell lung cancer and significant comorbidity</title><title>Annals of oncology</title><addtitle>Ann Oncol</addtitle><description>Background: Published trials of concurrent chemoradiotherapy (CCRT) in stage III non-small-cell lung cancer (NSCLC) generally excluded patients with significant comorbidity. We evaluated outcomes in patients who were selected by using radiation planning parameters and were considered, despite comorbidity, fit enough to receive cisplatin-based chemotherapy.
Patients and methods: From 2003 to 2008, 89 patients with stage III NSCLC fit to receive cisplatin-based chemotherapy and a V20 <42% underwent CCRT at one center outside clinical trials. Most received one cycle of cisplatin–gemcitabine, followed by two to three cycles of cisplatin–etoposide concurrent with involved-field thoracic radiotherapy between 46 and 66Gy.
Results: Median age was 64 years; performance status (PS) of zero, one or two in 20/64/5 patients; one or more comorbidities in 41.6%; 14% were treated previously for NSCLC. Median V20 was 26.6% (range 4%–39.4%). Grade III esophagitis and pneumonitis occurred in 28.1% and 7.9% of patients, respectively, while 4.5% died during treatment. Median overall survival was 18.2 months [95% confidence interval (CI) 13.1–23.3 months]. Independent prognostic factors for overall survival were PS (0 versus ≥1, P = 0.041) and planning target volume (P = 0.022).
Conclusions: Patients with significant comorbidity who are fit to undergo cisplatin-based CCRT achieve median survivals similar to that reported in phase III trials and with relatively few late toxic effects.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antineoplastic agents</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Carcinoma, Non-Small-Cell Lung - drug therapy</subject><subject>Carcinoma, Non-Small-Cell Lung - radiotherapy</subject><subject>Charlson comorbidity index</subject><subject>Cisplatin - administration & dosage</subject><subject>Combined Modality Therapy</subject><subject>Comorbidity</subject><subject>concurrent chemoradiotherapy</subject><subject>Deoxycytidine - administration & dosage</subject><subject>Deoxycytidine - analogs & derivatives</subject><subject>Etoposide - administration & dosage</subject><subject>Female</subject><subject>Humans</subject><subject>Lung Neoplasms - drug therapy</subject><subject>Lung Neoplasms - radiotherapy</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neoplasm Staging</subject><subject>patient selection</subject><subject>Pharmacology. Drug treatments</subject><subject>Pneumology</subject><subject>stage III NSCLC</subject><subject>Survival Rate</subject><subject>toxicity</subject><subject>Treatment Outcome</subject><subject>Tumors of the respiratory system and mediastinum</subject><issn>0923-7534</issn><issn>1569-8041</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kDFv2zAQRokiRe24HbMGXDIqpiiSMsfCSFoDAbyks3A-kjYLiXJIuoHz68tCTjt1OuDu4cN3j5Cbmt3XTDdLCGEMuBzMS1OrD2ReS6WrFRP1FZkzzZuqlY2YkeuUfjLGlOb6E5lxJrUUks_J2_aUcRxsoqOjWJJOMdqQKR7sMEYwfswHG-F4pj7QI2Rfjom--nygKcPe0s1mQ0uDKg3Q9xXavqf9KewpQkAbKQRDk98H73zZlNyxxO688fn8mXx00Cf75TIX5Mfjw_P6e_W0_bZZf32qUDCdK6GAoQAOEnUrpdkhV-1qpZxw0hmU3CFjQjW6Ea0xwI02K9XwWlgAIYqBBammXIxjStG67hj9APHc1az747CbHHaTw8LfTvzxtBus-Uu_SyvA3QWAhNC7WF716R8nmCoNWeHaibPlu1_exi5h8YfW-Ggxd2b0_6nwG8Zrkoc</recordid><startdate>201101</startdate><enddate>201101</enddate><creator>Phernambucq, E.C.J.</creator><creator>Spoelstra, F.O.B.</creator><creator>Verbakel, W.F.A.R.</creator><creator>Postmus, P.E.</creator><creator>Melissant, C.F.</creator><creator>Maassen van den Brink, K.I.</creator><creator>Frings, V.</creator><creator>van de Ven, P.M.</creator><creator>Smit, E.F.</creator><creator>Senan, S.</creator><general>Elsevier Ltd</general><general>Oxford University Press</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>201101</creationdate><title>Outcomes of concurrent chemoradiotherapy in patients with stage III non-small-cell lung cancer and significant comorbidity</title><author>Phernambucq, E.C.J. ; Spoelstra, F.O.B. ; Verbakel, W.F.A.R. ; Postmus, P.E. ; Melissant, C.F. ; Maassen van den Brink, K.I. ; Frings, V. ; van de Ven, P.M. ; Smit, E.F. ; Senan, S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c409t-46a0c4a2a5c9755dbc267886f4f5fdc52fc004639347dda2d9d863214eaa44923</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Antineoplastic agents</topic><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Carcinoma, Non-Small-Cell Lung - drug therapy</topic><topic>Carcinoma, Non-Small-Cell Lung - radiotherapy</topic><topic>Charlson comorbidity index</topic><topic>Cisplatin - administration & dosage</topic><topic>Combined Modality Therapy</topic><topic>Comorbidity</topic><topic>concurrent chemoradiotherapy</topic><topic>Deoxycytidine - administration & dosage</topic><topic>Deoxycytidine - analogs & derivatives</topic><topic>Etoposide - administration & dosage</topic><topic>Female</topic><topic>Humans</topic><topic>Lung Neoplasms - drug therapy</topic><topic>Lung Neoplasms - radiotherapy</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neoplasm Staging</topic><topic>patient selection</topic><topic>Pharmacology. Drug treatments</topic><topic>Pneumology</topic><topic>stage III NSCLC</topic><topic>Survival Rate</topic><topic>toxicity</topic><topic>Treatment Outcome</topic><topic>Tumors of the respiratory system and mediastinum</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Phernambucq, E.C.J.</creatorcontrib><creatorcontrib>Spoelstra, F.O.B.</creatorcontrib><creatorcontrib>Verbakel, W.F.A.R.</creatorcontrib><creatorcontrib>Postmus, P.E.</creatorcontrib><creatorcontrib>Melissant, C.F.</creatorcontrib><creatorcontrib>Maassen van den Brink, K.I.</creatorcontrib><creatorcontrib>Frings, V.</creatorcontrib><creatorcontrib>van de Ven, P.M.</creatorcontrib><creatorcontrib>Smit, E.F.</creatorcontrib><creatorcontrib>Senan, S.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>Annals of oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Phernambucq, E.C.J.</au><au>Spoelstra, F.O.B.</au><au>Verbakel, W.F.A.R.</au><au>Postmus, P.E.</au><au>Melissant, C.F.</au><au>Maassen van den Brink, K.I.</au><au>Frings, V.</au><au>van de Ven, P.M.</au><au>Smit, E.F.</au><au>Senan, S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcomes of concurrent chemoradiotherapy in patients with stage III non-small-cell lung cancer and significant comorbidity</atitle><jtitle>Annals of oncology</jtitle><addtitle>Ann Oncol</addtitle><date>2011-01</date><risdate>2011</risdate><volume>22</volume><issue>1</issue><spage>132</spage><epage>138</epage><pages>132-138</pages><issn>0923-7534</issn><eissn>1569-8041</eissn><abstract>Background: Published trials of concurrent chemoradiotherapy (CCRT) in stage III non-small-cell lung cancer (NSCLC) generally excluded patients with significant comorbidity. We evaluated outcomes in patients who were selected by using radiation planning parameters and were considered, despite comorbidity, fit enough to receive cisplatin-based chemotherapy.
Patients and methods: From 2003 to 2008, 89 patients with stage III NSCLC fit to receive cisplatin-based chemotherapy and a V20 <42% underwent CCRT at one center outside clinical trials. Most received one cycle of cisplatin–gemcitabine, followed by two to three cycles of cisplatin–etoposide concurrent with involved-field thoracic radiotherapy between 46 and 66Gy.
Results: Median age was 64 years; performance status (PS) of zero, one or two in 20/64/5 patients; one or more comorbidities in 41.6%; 14% were treated previously for NSCLC. Median V20 was 26.6% (range 4%–39.4%). Grade III esophagitis and pneumonitis occurred in 28.1% and 7.9% of patients, respectively, while 4.5% died during treatment. Median overall survival was 18.2 months [95% confidence interval (CI) 13.1–23.3 months]. Independent prognostic factors for overall survival were PS (0 versus ≥1, P = 0.041) and planning target volume (P = 0.022).
Conclusions: Patients with significant comorbidity who are fit to undergo cisplatin-based CCRT achieve median survivals similar to that reported in phase III trials and with relatively few late toxic effects.</abstract><cop>Oxford</cop><pub>Elsevier Ltd</pub><pmid>20595452</pmid><doi>10.1093/annonc/mdq316</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Antineoplastic agents Antineoplastic Combined Chemotherapy Protocols - therapeutic use Biological and medical sciences Carcinoma, Non-Small-Cell Lung - drug therapy Carcinoma, Non-Small-Cell Lung - radiotherapy Charlson comorbidity index Cisplatin - administration & dosage Combined Modality Therapy Comorbidity concurrent chemoradiotherapy Deoxycytidine - administration & dosage Deoxycytidine - analogs & derivatives Etoposide - administration & dosage Female Humans Lung Neoplasms - drug therapy Lung Neoplasms - radiotherapy Male Medical sciences Middle Aged Neoplasm Staging patient selection Pharmacology. Drug treatments Pneumology stage III NSCLC Survival Rate toxicity Treatment Outcome Tumors of the respiratory system and mediastinum |
| title | Outcomes of concurrent chemoradiotherapy in patients with stage III non-small-cell lung cancer and significant comorbidity |
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