Neo-adjuvant Chemo-Radiation to 60 Gray Followed by Surgery for Locally Advanced Non-Small Cell Lung Cancer Patients: Evaluation of Trimodality Strategy
Neoadjuvant chemo-radiation therapy (CRT) dosages in locally advanced non-small cell lung cancer (NSCLC) were traditionally limited to 45 Gray (Gy). To retrospectively analyze outcomes of patients treated with 60 Gy CRT followed by surgery. A retrospective chart review identified patients selected f...
Gespeichert in:
| Veröffentlicht in: | The Israel Medical Association journal 2017-10, Vol.19 (10), p.614-619 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 619 |
|---|---|
| container_issue | 10 |
| container_start_page | 614 |
| container_title | The Israel Medical Association journal |
| container_volume | 19 |
| creator | Appel, Sarit Goldstein, Jeffry Perelman, Marina Rabin, Tatiana Urban, Damien Onn, Amir Shulimzon, Tiberiu R Weiss, Ilana Lieberman, Sivan Marom, Edith M Golan, Nir Simansky, David Ben-Nun, Alon Lawrence, Yaacov Richard Bar, Jair Symon, Zvi |
| description | Neoadjuvant chemo-radiation therapy (CRT) dosages in locally advanced non-small cell lung cancer (NSCLC) were traditionally limited to 45 Gray (Gy).
To retrospectively analyze outcomes of patients treated with 60 Gy CRT followed by surgery.
A retrospective chart review identified patients selected for CRT to 60 Gy followed by surgery between August 2012 and April 2016. Selection for surgery was based on the extent of disease, cardiopulmonary function, and response to treatment. Pathological response after neoadjuvant CRT was scored using the modified tumor regression grading. Local control (LC), disease free survival (DFS), and overall survival (OS) were estimated by the Kaplan-Meier method.
Our cohort included 52 patients: 75% (39/52) were stage IIIA. A radiation dose of 60 Gy (range 50-62Gy) was delivered in 82.7%. Surgeries performed included: lobectomy, chest-wall resection, and pneumonectomy in 67.3%, 13.4%, and 19.2%, respectively. At median follow-up of 22.4 months, the 3 year OS was 74% (95% confidence interval [CI] 52-87%), LC was 84% (95%CI 65-93), and DFS 35% (95%CI 14-59). Grade 4-5 postoperative complications were observed in 17.3% of cases and included chest wall necrosis (5.7%), bronco-pleural fistula (7.7%), and death (3.8%). A major pathologic regression with < 10% residual tumor occurred in 68.7% of patients (36/52) and showed a trend to improved OS (P = 0.1). Pneumonectomy cases had statistically worse OS (P = 0.01).
Major pathologic regression was observed 68.7% with 60 Gy neoadjuvant CRT with a trend to improved survival. Pneumonectomy correlated with worse survival. |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_miscellaneous_1961032451</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1961032451</sourcerecordid><originalsourceid>FETCH-LOGICAL-p211t-474aabd5b9e92dd01e7517521a24df53d3e34d33aeeb1048ee3609515c3c783f3</originalsourceid><addsrcrecordid>eNo1kEFPg0AQhTlobK3-BTNHLyS7LEvBW0PaakKqsfVMBnaoNMDWZanhn_hzXdN6mUnmvXzz8q68KZeR9DmL44l32_cHxgIpWXLjTYKEMxGIeOr9bEj7qA7DCTsL6Se12n9HVaOtdQdWQ8RgbXCElW4a_U0KihG2g9mTGaHSBjJdYtOMsFCOUDp9ozt_27obpORGNnR7SP8kA2-OSp3tn2B5wmY4_9AV7EzdaoVNbR3bGrS0H--86wqbnu4ve-Z9rJa79NnPXtcv6SLzjwHn1g_nIWKhZJFQEijFOM0ln8uAYxCqSgolSIRKCCQqOAtjIhGxRHJZinIei0rMvMcz92j010C9zdu6L11y7EgPfc6T6K-rUHJnfbhYh6IllR9dbDRj_t-m-AWrOXDx</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1961032451</pqid></control><display><type>article</type><title>Neo-adjuvant Chemo-Radiation to 60 Gray Followed by Surgery for Locally Advanced Non-Small Cell Lung Cancer Patients: Evaluation of Trimodality Strategy</title><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Alma/SFX Local Collection</source><creator>Appel, Sarit ; Goldstein, Jeffry ; Perelman, Marina ; Rabin, Tatiana ; Urban, Damien ; Onn, Amir ; Shulimzon, Tiberiu R ; Weiss, Ilana ; Lieberman, Sivan ; Marom, Edith M ; Golan, Nir ; Simansky, David ; Ben-Nun, Alon ; Lawrence, Yaacov Richard ; Bar, Jair ; Symon, Zvi</creator><creatorcontrib>Appel, Sarit ; Goldstein, Jeffry ; Perelman, Marina ; Rabin, Tatiana ; Urban, Damien ; Onn, Amir ; Shulimzon, Tiberiu R ; Weiss, Ilana ; Lieberman, Sivan ; Marom, Edith M ; Golan, Nir ; Simansky, David ; Ben-Nun, Alon ; Lawrence, Yaacov Richard ; Bar, Jair ; Symon, Zvi</creatorcontrib><description>Neoadjuvant chemo-radiation therapy (CRT) dosages in locally advanced non-small cell lung cancer (NSCLC) were traditionally limited to 45 Gray (Gy).
To retrospectively analyze outcomes of patients treated with 60 Gy CRT followed by surgery.
A retrospective chart review identified patients selected for CRT to 60 Gy followed by surgery between August 2012 and April 2016. Selection for surgery was based on the extent of disease, cardiopulmonary function, and response to treatment. Pathological response after neoadjuvant CRT was scored using the modified tumor regression grading. Local control (LC), disease free survival (DFS), and overall survival (OS) were estimated by the Kaplan-Meier method.
Our cohort included 52 patients: 75% (39/52) were stage IIIA. A radiation dose of 60 Gy (range 50-62Gy) was delivered in 82.7%. Surgeries performed included: lobectomy, chest-wall resection, and pneumonectomy in 67.3%, 13.4%, and 19.2%, respectively. At median follow-up of 22.4 months, the 3 year OS was 74% (95% confidence interval [CI] 52-87%), LC was 84% (95%CI 65-93), and DFS 35% (95%CI 14-59). Grade 4-5 postoperative complications were observed in 17.3% of cases and included chest wall necrosis (5.7%), bronco-pleural fistula (7.7%), and death (3.8%). A major pathologic regression with < 10% residual tumor occurred in 68.7% of patients (36/52) and showed a trend to improved OS (P = 0.1). Pneumonectomy cases had statistically worse OS (P = 0.01).
Major pathologic regression was observed 68.7% with 60 Gy neoadjuvant CRT with a trend to improved survival. Pneumonectomy correlated with worse survival.</description><identifier>ISSN: 1565-1088</identifier><identifier>PMID: 29103238</identifier><language>eng</language><publisher>Israel</publisher><ispartof>The Israel Medical Association journal, 2017-10, Vol.19 (10), p.614-619</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29103238$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Appel, Sarit</creatorcontrib><creatorcontrib>Goldstein, Jeffry</creatorcontrib><creatorcontrib>Perelman, Marina</creatorcontrib><creatorcontrib>Rabin, Tatiana</creatorcontrib><creatorcontrib>Urban, Damien</creatorcontrib><creatorcontrib>Onn, Amir</creatorcontrib><creatorcontrib>Shulimzon, Tiberiu R</creatorcontrib><creatorcontrib>Weiss, Ilana</creatorcontrib><creatorcontrib>Lieberman, Sivan</creatorcontrib><creatorcontrib>Marom, Edith M</creatorcontrib><creatorcontrib>Golan, Nir</creatorcontrib><creatorcontrib>Simansky, David</creatorcontrib><creatorcontrib>Ben-Nun, Alon</creatorcontrib><creatorcontrib>Lawrence, Yaacov Richard</creatorcontrib><creatorcontrib>Bar, Jair</creatorcontrib><creatorcontrib>Symon, Zvi</creatorcontrib><title>Neo-adjuvant Chemo-Radiation to 60 Gray Followed by Surgery for Locally Advanced Non-Small Cell Lung Cancer Patients: Evaluation of Trimodality Strategy</title><title>The Israel Medical Association journal</title><addtitle>Isr Med Assoc J</addtitle><description>Neoadjuvant chemo-radiation therapy (CRT) dosages in locally advanced non-small cell lung cancer (NSCLC) were traditionally limited to 45 Gray (Gy).
To retrospectively analyze outcomes of patients treated with 60 Gy CRT followed by surgery.
A retrospective chart review identified patients selected for CRT to 60 Gy followed by surgery between August 2012 and April 2016. Selection for surgery was based on the extent of disease, cardiopulmonary function, and response to treatment. Pathological response after neoadjuvant CRT was scored using the modified tumor regression grading. Local control (LC), disease free survival (DFS), and overall survival (OS) were estimated by the Kaplan-Meier method.
Our cohort included 52 patients: 75% (39/52) were stage IIIA. A radiation dose of 60 Gy (range 50-62Gy) was delivered in 82.7%. Surgeries performed included: lobectomy, chest-wall resection, and pneumonectomy in 67.3%, 13.4%, and 19.2%, respectively. At median follow-up of 22.4 months, the 3 year OS was 74% (95% confidence interval [CI] 52-87%), LC was 84% (95%CI 65-93), and DFS 35% (95%CI 14-59). Grade 4-5 postoperative complications were observed in 17.3% of cases and included chest wall necrosis (5.7%), bronco-pleural fistula (7.7%), and death (3.8%). A major pathologic regression with < 10% residual tumor occurred in 68.7% of patients (36/52) and showed a trend to improved OS (P = 0.1). Pneumonectomy cases had statistically worse OS (P = 0.01).
Major pathologic regression was observed 68.7% with 60 Gy neoadjuvant CRT with a trend to improved survival. Pneumonectomy correlated with worse survival.</description><issn>1565-1088</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><recordid>eNo1kEFPg0AQhTlobK3-BTNHLyS7LEvBW0PaakKqsfVMBnaoNMDWZanhn_hzXdN6mUnmvXzz8q68KZeR9DmL44l32_cHxgIpWXLjTYKEMxGIeOr9bEj7qA7DCTsL6Se12n9HVaOtdQdWQ8RgbXCElW4a_U0KihG2g9mTGaHSBjJdYtOMsFCOUDp9ozt_27obpORGNnR7SP8kA2-OSp3tn2B5wmY4_9AV7EzdaoVNbR3bGrS0H--86wqbnu4ve-Z9rJa79NnPXtcv6SLzjwHn1g_nIWKhZJFQEijFOM0ln8uAYxCqSgolSIRKCCQqOAtjIhGxRHJZinIei0rMvMcz92j010C9zdu6L11y7EgPfc6T6K-rUHJnfbhYh6IllR9dbDRj_t-m-AWrOXDx</recordid><startdate>201710</startdate><enddate>201710</enddate><creator>Appel, Sarit</creator><creator>Goldstein, Jeffry</creator><creator>Perelman, Marina</creator><creator>Rabin, Tatiana</creator><creator>Urban, Damien</creator><creator>Onn, Amir</creator><creator>Shulimzon, Tiberiu R</creator><creator>Weiss, Ilana</creator><creator>Lieberman, Sivan</creator><creator>Marom, Edith M</creator><creator>Golan, Nir</creator><creator>Simansky, David</creator><creator>Ben-Nun, Alon</creator><creator>Lawrence, Yaacov Richard</creator><creator>Bar, Jair</creator><creator>Symon, Zvi</creator><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>201710</creationdate><title>Neo-adjuvant Chemo-Radiation to 60 Gray Followed by Surgery for Locally Advanced Non-Small Cell Lung Cancer Patients: Evaluation of Trimodality Strategy</title><author>Appel, Sarit ; Goldstein, Jeffry ; Perelman, Marina ; Rabin, Tatiana ; Urban, Damien ; Onn, Amir ; Shulimzon, Tiberiu R ; Weiss, Ilana ; Lieberman, Sivan ; Marom, Edith M ; Golan, Nir ; Simansky, David ; Ben-Nun, Alon ; Lawrence, Yaacov Richard ; Bar, Jair ; Symon, Zvi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p211t-474aabd5b9e92dd01e7517521a24df53d3e34d33aeeb1048ee3609515c3c783f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Appel, Sarit</creatorcontrib><creatorcontrib>Goldstein, Jeffry</creatorcontrib><creatorcontrib>Perelman, Marina</creatorcontrib><creatorcontrib>Rabin, Tatiana</creatorcontrib><creatorcontrib>Urban, Damien</creatorcontrib><creatorcontrib>Onn, Amir</creatorcontrib><creatorcontrib>Shulimzon, Tiberiu R</creatorcontrib><creatorcontrib>Weiss, Ilana</creatorcontrib><creatorcontrib>Lieberman, Sivan</creatorcontrib><creatorcontrib>Marom, Edith M</creatorcontrib><creatorcontrib>Golan, Nir</creatorcontrib><creatorcontrib>Simansky, David</creatorcontrib><creatorcontrib>Ben-Nun, Alon</creatorcontrib><creatorcontrib>Lawrence, Yaacov Richard</creatorcontrib><creatorcontrib>Bar, Jair</creatorcontrib><creatorcontrib>Symon, Zvi</creatorcontrib><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>The Israel Medical Association journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Appel, Sarit</au><au>Goldstein, Jeffry</au><au>Perelman, Marina</au><au>Rabin, Tatiana</au><au>Urban, Damien</au><au>Onn, Amir</au><au>Shulimzon, Tiberiu R</au><au>Weiss, Ilana</au><au>Lieberman, Sivan</au><au>Marom, Edith M</au><au>Golan, Nir</au><au>Simansky, David</au><au>Ben-Nun, Alon</au><au>Lawrence, Yaacov Richard</au><au>Bar, Jair</au><au>Symon, Zvi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Neo-adjuvant Chemo-Radiation to 60 Gray Followed by Surgery for Locally Advanced Non-Small Cell Lung Cancer Patients: Evaluation of Trimodality Strategy</atitle><jtitle>The Israel Medical Association journal</jtitle><addtitle>Isr Med Assoc J</addtitle><date>2017-10</date><risdate>2017</risdate><volume>19</volume><issue>10</issue><spage>614</spage><epage>619</epage><pages>614-619</pages><issn>1565-1088</issn><abstract>Neoadjuvant chemo-radiation therapy (CRT) dosages in locally advanced non-small cell lung cancer (NSCLC) were traditionally limited to 45 Gray (Gy).
To retrospectively analyze outcomes of patients treated with 60 Gy CRT followed by surgery.
A retrospective chart review identified patients selected for CRT to 60 Gy followed by surgery between August 2012 and April 2016. Selection for surgery was based on the extent of disease, cardiopulmonary function, and response to treatment. Pathological response after neoadjuvant CRT was scored using the modified tumor regression grading. Local control (LC), disease free survival (DFS), and overall survival (OS) were estimated by the Kaplan-Meier method.
Our cohort included 52 patients: 75% (39/52) were stage IIIA. A radiation dose of 60 Gy (range 50-62Gy) was delivered in 82.7%. Surgeries performed included: lobectomy, chest-wall resection, and pneumonectomy in 67.3%, 13.4%, and 19.2%, respectively. At median follow-up of 22.4 months, the 3 year OS was 74% (95% confidence interval [CI] 52-87%), LC was 84% (95%CI 65-93), and DFS 35% (95%CI 14-59). Grade 4-5 postoperative complications were observed in 17.3% of cases and included chest wall necrosis (5.7%), bronco-pleural fistula (7.7%), and death (3.8%). A major pathologic regression with < 10% residual tumor occurred in 68.7% of patients (36/52) and showed a trend to improved OS (P = 0.1). Pneumonectomy cases had statistically worse OS (P = 0.01).
Major pathologic regression was observed 68.7% with 60 Gy neoadjuvant CRT with a trend to improved survival. Pneumonectomy correlated with worse survival.</abstract><cop>Israel</cop><pmid>29103238</pmid><tpages>6</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1565-1088 |
| ispartof | The Israel Medical Association journal, 2017-10, Vol.19 (10), p.614-619 |
| issn | 1565-1088 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1961032451 |
| source | Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| title | Neo-adjuvant Chemo-Radiation to 60 Gray Followed by Surgery for Locally Advanced Non-Small Cell Lung Cancer Patients: Evaluation of Trimodality Strategy |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-06T17%3A48%3A22IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Neo-adjuvant%20Chemo-Radiation%20to%2060%20Gray%20Followed%20by%20Surgery%20for%20Locally%20Advanced%20Non-Small%20Cell%20Lung%20Cancer%20Patients:%20Evaluation%20of%20Trimodality%20Strategy&rft.jtitle=The%20Israel%20Medical%20Association%20journal&rft.au=Appel,%20Sarit&rft.date=2017-10&rft.volume=19&rft.issue=10&rft.spage=614&rft.epage=619&rft.pages=614-619&rft.issn=1565-1088&rft_id=info:doi/&rft_dat=%3Cproquest_pubme%3E1961032451%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1961032451&rft_id=info:pmid/29103238&rfr_iscdi=true |