Factors Affecting the Risk of Brain Metastases After Definitive Chemoradiation for Locally Advanced Non–Small-Cell Lung Carcinoma
As therapy for locally advanced non-small-cell lung carcinoma (NSCLC) improves, brain metastases (BM) may become a greater problem. We analyzed our chemoradiation experience for patients at highest risk for the brain as the first failure site. Records for 150 consecutive patients with stage II/III N...
Gespeichert in:
| Veröffentlicht in: | Journal of clinical oncology 2001-03, Vol.19 (5), p.1344-1349 |
|---|---|
| Hauptverfasser: | , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 1349 |
|---|---|
| container_issue | 5 |
| container_start_page | 1344 |
| container_title | Journal of clinical oncology |
| container_volume | 19 |
| creator | ROBNETT, Theodore J MACHTAY, Mitchell STEVENSON, James P ALGAZY, Kenneth M HAHN, Stephen M |
| description | As therapy for locally advanced non-small-cell lung carcinoma (NSCLC) improves, brain metastases (BM) may become a greater problem. We analyzed our chemoradiation experience for patients at highest risk for the brain as the first failure site.
Records for 150 consecutive patients with stage II/III NSCLC treated definitively with chemoradiation from June 1992 to June 1998 at the University of Pennsylvania were reviewed. Most patients (89%) received cisplatin, paclitaxel, or both. All had negative brain imaging before treatment. Posttreatment brain imaging was performed for suspicious symptoms. Incidence of BM was examined as a function of age, sex, histology, stage, performance status, weight loss, tumor location, surgery, radiation dose, initial radiation field, chemotherapy regimen, and chemotherapy timing.
Crude and 2-year actuarial rates of BM were 19% and 30%, respectively. Among pretreatment parameters, stage IIIB was associated with a higher risk of BM (P |
| doi_str_mv | 10.1200/jco.2001.19.5.1344 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_76965694</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>76965694</sourcerecordid><originalsourceid>FETCH-LOGICAL-c424t-8272b8fb9b94d3f001d1d1b97bc20ed0a6a8ad0838dc580f4c1d7a358549c2063</originalsourceid><addsrcrecordid>eNpNkdtqFDEYgIModlt9AS8kIHg30xwnM5fraG1lteABvAuZHLqpM5OaZFt6V_ARfEOfxAxdrCTww8_3H_IFgBcY1ZggdHypQ10irnFX8xpTxh6BFeZEVEJw_hiskKCkwi39fgAOU7osKGspfwoOMCYUMSFW4NeJ0jnEBNfOWZ39fAHz1sLPPv2AwcE3UfkZfrRZpXLtgmUb4Vvr_Oyzv7aw39opRGW8yj7M0IUIN0GrcbyFa3OtZm0N_BTmP3e_v0wlW_V2HOFmV-b0Kmo_h0k9A0-cGpN9vo9H4NvJu6_9abU5f3_WrzeVZoTlqiWCDK0buqFjhrryGlPO0IlBE2QNUo1qlUEtbY3mLXJMYyMU5S1nXSEaegRe3_e9iuHnzqYsJ5902UfNNuySFE3X8KZjBST3oI4hpWidvIp-UvFWYiQX9fJDfy4X9RJ3kstFfSl6ue--GyZrHkr2rgvwag-oVAS5WOT49I_rGEL0vyW3_mJ746OVafFWmhJZPvxh3l9rjJrx</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>76965694</pqid></control><display><type>article</type><title>Factors Affecting the Risk of Brain Metastases After Definitive Chemoradiation for Locally Advanced Non–Small-Cell Lung Carcinoma</title><source>MEDLINE</source><source>Journals@Ovid Complete</source><creator>ROBNETT, Theodore J ; MACHTAY, Mitchell ; STEVENSON, James P ; ALGAZY, Kenneth M ; HAHN, Stephen M</creator><creatorcontrib>ROBNETT, Theodore J ; MACHTAY, Mitchell ; STEVENSON, James P ; ALGAZY, Kenneth M ; HAHN, Stephen M</creatorcontrib><description><![CDATA[As therapy for locally advanced non-small-cell lung carcinoma (NSCLC) improves, brain metastases (BM) may become a greater problem. We analyzed our chemoradiation experience for patients at highest risk for the brain as the first failure site.
Records for 150 consecutive patients with stage II/III NSCLC treated definitively with chemoradiation from June 1992 to June 1998 at the University of Pennsylvania were reviewed. Most patients (89%) received cisplatin, paclitaxel, or both. All had negative brain imaging before treatment. Posttreatment brain imaging was performed for suspicious symptoms. Incidence of BM was examined as a function of age, sex, histology, stage, performance status, weight loss, tumor location, surgery, radiation dose, initial radiation field, chemotherapy regimen, and chemotherapy timing.
Crude and 2-year actuarial rates of BM were 19% and 30%, respectively. Among pretreatment parameters, stage IIIB was associated with a higher risk of BM (P <.04) versus stage II/IIIA. Histology alone was not significant (P <.12), although patients with IIIB nonsquamous tumors had an exceptionally high 2-year BM rate of 42% (P <.01 v all others). Examining treatment-related parameters, crude and 2-year actuarial risk of BM were 27% and 39%, respectively, in patients receiving chemotherapy before radiotherapy and 15% and 20%, respectively, when radiotherapy was not delayed (P <.05). On multivariate analysis, timing of chemotherapy (P <.01) and stage IIIA versus IIIB (P <.01) remained significant.
Patients with later stage, nonsquamous NSCLC, particularly those receiving induction chemotherapy, have sufficiently common BM rates to justify future trials including prophylactic cranial irradiation.]]></description><identifier>ISSN: 0732-183X</identifier><identifier>EISSN: 1527-7755</identifier><identifier>DOI: 10.1200/jco.2001.19.5.1344</identifier><identifier>PMID: 11230477</identifier><language>eng</language><publisher>Baltimore, MD: American Society of Clinical Oncology</publisher><subject>Adult ; Aged ; Antineoplastic agents ; Biological and medical sciences ; Brain Neoplasms - etiology ; Brain Neoplasms - radiotherapy ; Brain Neoplasms - secondary ; Carcinoma, Non-Small-Cell Lung - drug therapy ; Carcinoma, Non-Small-Cell Lung - radiotherapy ; Carcinoma, Non-Small-Cell Lung - secondary ; Combined Modality Therapy ; Combined treatments (chemotherapy of immunotherapy associated with an other treatment) ; Cranial Irradiation ; Female ; Humans ; Lung Neoplasms - drug therapy ; Lung Neoplasms - pathology ; Lung Neoplasms - radiotherapy ; Male ; Medical sciences ; Middle Aged ; Pharmacology. Drug treatments ; Prognosis ; Retrospective Studies ; Risk Factors</subject><ispartof>Journal of clinical oncology, 2001-03, Vol.19 (5), p.1344-1349</ispartof><rights>2001 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c424t-8272b8fb9b94d3f001d1d1b97bc20ed0a6a8ad0838dc580f4c1d7a358549c2063</citedby><cites>FETCH-LOGICAL-c424t-8272b8fb9b94d3f001d1d1b97bc20ed0a6a8ad0838dc580f4c1d7a358549c2063</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=940036$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11230477$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>ROBNETT, Theodore J</creatorcontrib><creatorcontrib>MACHTAY, Mitchell</creatorcontrib><creatorcontrib>STEVENSON, James P</creatorcontrib><creatorcontrib>ALGAZY, Kenneth M</creatorcontrib><creatorcontrib>HAHN, Stephen M</creatorcontrib><title>Factors Affecting the Risk of Brain Metastases After Definitive Chemoradiation for Locally Advanced Non–Small-Cell Lung Carcinoma</title><title>Journal of clinical oncology</title><addtitle>J Clin Oncol</addtitle><description><![CDATA[As therapy for locally advanced non-small-cell lung carcinoma (NSCLC) improves, brain metastases (BM) may become a greater problem. We analyzed our chemoradiation experience for patients at highest risk for the brain as the first failure site.
Records for 150 consecutive patients with stage II/III NSCLC treated definitively with chemoradiation from June 1992 to June 1998 at the University of Pennsylvania were reviewed. Most patients (89%) received cisplatin, paclitaxel, or both. All had negative brain imaging before treatment. Posttreatment brain imaging was performed for suspicious symptoms. Incidence of BM was examined as a function of age, sex, histology, stage, performance status, weight loss, tumor location, surgery, radiation dose, initial radiation field, chemotherapy regimen, and chemotherapy timing.
Crude and 2-year actuarial rates of BM were 19% and 30%, respectively. Among pretreatment parameters, stage IIIB was associated with a higher risk of BM (P <.04) versus stage II/IIIA. Histology alone was not significant (P <.12), although patients with IIIB nonsquamous tumors had an exceptionally high 2-year BM rate of 42% (P <.01 v all others). Examining treatment-related parameters, crude and 2-year actuarial risk of BM were 27% and 39%, respectively, in patients receiving chemotherapy before radiotherapy and 15% and 20%, respectively, when radiotherapy was not delayed (P <.05). On multivariate analysis, timing of chemotherapy (P <.01) and stage IIIA versus IIIB (P <.01) remained significant.
Patients with later stage, nonsquamous NSCLC, particularly those receiving induction chemotherapy, have sufficiently common BM rates to justify future trials including prophylactic cranial irradiation.]]></description><subject>Adult</subject><subject>Aged</subject><subject>Antineoplastic agents</subject><subject>Biological and medical sciences</subject><subject>Brain Neoplasms - etiology</subject><subject>Brain Neoplasms - radiotherapy</subject><subject>Brain Neoplasms - secondary</subject><subject>Carcinoma, Non-Small-Cell Lung - drug therapy</subject><subject>Carcinoma, Non-Small-Cell Lung - radiotherapy</subject><subject>Carcinoma, Non-Small-Cell Lung - secondary</subject><subject>Combined Modality Therapy</subject><subject>Combined treatments (chemotherapy of immunotherapy associated with an other treatment)</subject><subject>Cranial Irradiation</subject><subject>Female</subject><subject>Humans</subject><subject>Lung Neoplasms - drug therapy</subject><subject>Lung Neoplasms - pathology</subject><subject>Lung Neoplasms - radiotherapy</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Pharmacology. Drug treatments</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><issn>0732-183X</issn><issn>1527-7755</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpNkdtqFDEYgIModlt9AS8kIHg30xwnM5fraG1lteABvAuZHLqpM5OaZFt6V_ARfEOfxAxdrCTww8_3H_IFgBcY1ZggdHypQ10irnFX8xpTxh6BFeZEVEJw_hiskKCkwi39fgAOU7osKGspfwoOMCYUMSFW4NeJ0jnEBNfOWZ39fAHz1sLPPv2AwcE3UfkZfrRZpXLtgmUb4Vvr_Oyzv7aw39opRGW8yj7M0IUIN0GrcbyFa3OtZm0N_BTmP3e_v0wlW_V2HOFmV-b0Kmo_h0k9A0-cGpN9vo9H4NvJu6_9abU5f3_WrzeVZoTlqiWCDK0buqFjhrryGlPO0IlBE2QNUo1qlUEtbY3mLXJMYyMU5S1nXSEaegRe3_e9iuHnzqYsJ5902UfNNuySFE3X8KZjBST3oI4hpWidvIp-UvFWYiQX9fJDfy4X9RJ3kstFfSl6ue--GyZrHkr2rgvwag-oVAS5WOT49I_rGEL0vyW3_mJ746OVafFWmhJZPvxh3l9rjJrx</recordid><startdate>20010301</startdate><enddate>20010301</enddate><creator>ROBNETT, Theodore J</creator><creator>MACHTAY, Mitchell</creator><creator>STEVENSON, James P</creator><creator>ALGAZY, Kenneth M</creator><creator>HAHN, Stephen M</creator><general>American Society of Clinical Oncology</general><general>Lippincott Williams & Wilkins</general><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><scope>7X8</scope></search><sort><creationdate>20010301</creationdate><title>Factors Affecting the Risk of Brain Metastases After Definitive Chemoradiation for Locally Advanced Non–Small-Cell Lung Carcinoma</title><author>ROBNETT, Theodore J ; MACHTAY, Mitchell ; STEVENSON, James P ; ALGAZY, Kenneth M ; HAHN, Stephen M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c424t-8272b8fb9b94d3f001d1d1b97bc20ed0a6a8ad0838dc580f4c1d7a358549c2063</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Antineoplastic agents</topic><topic>Biological and medical sciences</topic><topic>Brain Neoplasms - etiology</topic><topic>Brain Neoplasms - radiotherapy</topic><topic>Brain Neoplasms - secondary</topic><topic>Carcinoma, Non-Small-Cell Lung - drug therapy</topic><topic>Carcinoma, Non-Small-Cell Lung - radiotherapy</topic><topic>Carcinoma, Non-Small-Cell Lung - secondary</topic><topic>Combined Modality Therapy</topic><topic>Combined treatments (chemotherapy of immunotherapy associated with an other treatment)</topic><topic>Cranial Irradiation</topic><topic>Female</topic><topic>Humans</topic><topic>Lung Neoplasms - drug therapy</topic><topic>Lung Neoplasms - pathology</topic><topic>Lung Neoplasms - radiotherapy</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Pharmacology. Drug treatments</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>ROBNETT, Theodore J</creatorcontrib><creatorcontrib>MACHTAY, Mitchell</creatorcontrib><creatorcontrib>STEVENSON, James P</creatorcontrib><creatorcontrib>ALGAZY, Kenneth M</creatorcontrib><creatorcontrib>HAHN, Stephen M</creatorcontrib><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><collection>MEDLINE - Academic</collection><jtitle>Journal of clinical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>ROBNETT, Theodore J</au><au>MACHTAY, Mitchell</au><au>STEVENSON, James P</au><au>ALGAZY, Kenneth M</au><au>HAHN, Stephen M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Factors Affecting the Risk of Brain Metastases After Definitive Chemoradiation for Locally Advanced Non–Small-Cell Lung Carcinoma</atitle><jtitle>Journal of clinical oncology</jtitle><addtitle>J Clin Oncol</addtitle><date>2001-03-01</date><risdate>2001</risdate><volume>19</volume><issue>5</issue><spage>1344</spage><epage>1349</epage><pages>1344-1349</pages><issn>0732-183X</issn><eissn>1527-7755</eissn><abstract><![CDATA[As therapy for locally advanced non-small-cell lung carcinoma (NSCLC) improves, brain metastases (BM) may become a greater problem. We analyzed our chemoradiation experience for patients at highest risk for the brain as the first failure site.
Records for 150 consecutive patients with stage II/III NSCLC treated definitively with chemoradiation from June 1992 to June 1998 at the University of Pennsylvania were reviewed. Most patients (89%) received cisplatin, paclitaxel, or both. All had negative brain imaging before treatment. Posttreatment brain imaging was performed for suspicious symptoms. Incidence of BM was examined as a function of age, sex, histology, stage, performance status, weight loss, tumor location, surgery, radiation dose, initial radiation field, chemotherapy regimen, and chemotherapy timing.
Crude and 2-year actuarial rates of BM were 19% and 30%, respectively. Among pretreatment parameters, stage IIIB was associated with a higher risk of BM (P <.04) versus stage II/IIIA. Histology alone was not significant (P <.12), although patients with IIIB nonsquamous tumors had an exceptionally high 2-year BM rate of 42% (P <.01 v all others). Examining treatment-related parameters, crude and 2-year actuarial risk of BM were 27% and 39%, respectively, in patients receiving chemotherapy before radiotherapy and 15% and 20%, respectively, when radiotherapy was not delayed (P <.05). On multivariate analysis, timing of chemotherapy (P <.01) and stage IIIA versus IIIB (P <.01) remained significant.
Patients with later stage, nonsquamous NSCLC, particularly those receiving induction chemotherapy, have sufficiently common BM rates to justify future trials including prophylactic cranial irradiation.]]></abstract><cop>Baltimore, MD</cop><pub>American Society of Clinical Oncology</pub><pmid>11230477</pmid><doi>10.1200/jco.2001.19.5.1344</doi><tpages>6</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0732-183X |
| ispartof | Journal of clinical oncology, 2001-03, Vol.19 (5), p.1344-1349 |
| issn | 0732-183X 1527-7755 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_76965694 |
| source | MEDLINE; Journals@Ovid Complete |
| subjects | Adult Aged Antineoplastic agents Biological and medical sciences Brain Neoplasms - etiology Brain Neoplasms - radiotherapy Brain Neoplasms - secondary Carcinoma, Non-Small-Cell Lung - drug therapy Carcinoma, Non-Small-Cell Lung - radiotherapy Carcinoma, Non-Small-Cell Lung - secondary Combined Modality Therapy Combined treatments (chemotherapy of immunotherapy associated with an other treatment) Cranial Irradiation Female Humans Lung Neoplasms - drug therapy Lung Neoplasms - pathology Lung Neoplasms - radiotherapy Male Medical sciences Middle Aged Pharmacology. Drug treatments Prognosis Retrospective Studies Risk Factors |
| title | Factors Affecting the Risk of Brain Metastases After Definitive Chemoradiation for Locally Advanced Non–Small-Cell Lung Carcinoma |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-10T10%3A05%3A33IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Factors%20Affecting%20the%20Risk%20of%20Brain%20Metastases%20After%20Definitive%20Chemoradiation%20for%20Locally%20Advanced%20Non%E2%80%93Small-Cell%20Lung%20Carcinoma&rft.jtitle=Journal%20of%20clinical%20oncology&rft.au=ROBNETT,%20Theodore%20J&rft.date=2001-03-01&rft.volume=19&rft.issue=5&rft.spage=1344&rft.epage=1349&rft.pages=1344-1349&rft.issn=0732-183X&rft.eissn=1527-7755&rft_id=info:doi/10.1200/jco.2001.19.5.1344&rft_dat=%3Cproquest_cross%3E76965694%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=76965694&rft_id=info:pmid/11230477&rfr_iscdi=true |