Treatment Outcomes of Different Prognostic Groups of Patients on Cancer and Leukemia Group B Trial 39801: Induction Chemotherapy Followed by Chemoradiotherapy Compared with Chemoradiotherapy Alone for Unresectable Stage III Non-small Cell Lung Cancer

In Cancer and Leukemia Group B 39801, we evaluated whether induction chemotherapy before concurrent chemoradiotherapy would result in improved survival and demonstrated no significant benefit from the addition of induction chemotherapy. The primary objective of this analysis was to dichotomize patie...

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Veröffentlicht in:	Journal of thoracic oncology 2009-09, Vol.4 (9), p.1117-1125
Hauptverfasser:	Stinchcombe, Thomas E., Hodgson, Lydia, Herndon, James E., Kelley, Michael J., Cicchetti, M Giulia, Ramnath, Nithya, Niell, Harvey B., Atkins, James N., Akerley, Wallace, Green, Mark R., Vokes, Everett E.
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Sprache:	eng
Schlagworte:	Adult Aged Aged, 80 and over CALGB Carcinoma, Non-Small-Cell Lung - mortality Carcinoma, Non-Small-Cell Lung - pathology Carcinoma, Non-Small-Cell Lung - therapy Chemoradiation Clinical Trials as Topic Combined Modality Therapy Female Humans Induction chemotherapy Locally advanced non-small cell lung cancer Lung Neoplasms - mortality Lung Neoplasms - pathology Lung Neoplasms - therapy Male Middle Aged Neoplasm Staging Prognosis Prognostic factors Proportional Hazards Models Treatment Outcome
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creator	Stinchcombe, Thomas E. Hodgson, Lydia Herndon, James E. Kelley, Michael J. Cicchetti, M Giulia Ramnath, Nithya Niell, Harvey B. Atkins, James N. Akerley, Wallace Green, Mark R. Vokes, Everett E.
description	In Cancer and Leukemia Group B 39801, we evaluated whether induction chemotherapy before concurrent chemoradiotherapy would result in improved survival and demonstrated no significant benefit from the addition of induction chemotherapy. The primary objective of this analysis was to dichotomize patients into prognostic groups using factors predictive of survival and to investigate whether induction chemotherapy was beneficial in either prognostic group. A Cox proportional hazard model was used to assess the impact on survival of the following factors: (≥70 versus
doi_str_mv	10.1097/JTO.0b013e3181b27b33
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The primary objective of this analysis was to dichotomize patients into prognostic groups using factors predictive of survival and to investigate whether induction chemotherapy was beneficial in either prognostic group. A Cox proportional hazard model was used to assess the impact on survival of the following factors: (≥70 versus <70 years), gender, race, stage (IIIB versus IIIA), hemoglobin (hgb) (<13 versus ≥13 g/dl), performance status (PS) (1 versus 0), weight loss (≥5% versus <5%), treatment arm, and the interaction between weight loss and hgb. Factors predictive of decreased survival were weight loss ≥5%, age ≥70 years, PS of 1, and hgb <13 g/dl (p < 0.05). Patients were classified as having ≥2 poor prognostic factors (n = 165) or ≤1 factor (n = 166). The hazard ratio (HR) for overall survival for the patients with ≥2 versus patients with ≤1 was 1.88 [95% confidence interval (CI), 1.49–2.37; p = <0.0001]; median survival times observed were 9 (95% CI, 8–11) and 18 (95% CI, 16–24) months, respectively. There was no significant difference in survival between treatment arms in patients with ≥2 factors (HR = 0.86, 95% CI, 0.63–1.17; p = 0.34) or ≤1 factor (HR = 0.97, 95% CI, 0.70–1.35; p = 0.87). There is no evidence that induction chemotherapy is beneficial in either prognostic group.]]></description><identifier>ISSN: 1556-0864</identifier><identifier>EISSN: 1556-1380</identifier><identifier>DOI: 10.1097/JTO.0b013e3181b27b33</identifier><identifier>PMID: 19652624</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Aged ; Aged, 80 and over ; CALGB ; Carcinoma, Non-Small-Cell Lung - mortality ; Carcinoma, Non-Small-Cell Lung - pathology ; Carcinoma, Non-Small-Cell Lung - therapy ; Chemoradiation ; Clinical Trials as Topic ; Combined Modality Therapy ; Female ; Humans ; Induction chemotherapy ; Locally advanced non-small cell lung cancer ; Lung Neoplasms - mortality ; Lung Neoplasms - pathology ; Lung Neoplasms - therapy ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Prognostic factors ; Proportional Hazards Models ; Treatment Outcome</subject><ispartof>Journal of thoracic oncology, 2009-09, Vol.4 (9), p.1117-1125</ispartof><rights>2009 International Association for the Study of Lung Cancer</rights><rights>2009International Association for the Study of Lung Cancer</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5103-6e50eee704d5d8a2f886afa2ee98fb7115e8b4426d87af8f64ddc25806728e763</citedby><cites>FETCH-LOGICAL-c5103-6e50eee704d5d8a2f886afa2ee98fb7115e8b4426d87af8f64ddc25806728e763</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19652624$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Stinchcombe, Thomas E.</creatorcontrib><creatorcontrib>Hodgson, Lydia</creatorcontrib><creatorcontrib>Herndon, James E.</creatorcontrib><creatorcontrib>Kelley, Michael J.</creatorcontrib><creatorcontrib>Cicchetti, M Giulia</creatorcontrib><creatorcontrib>Ramnath, Nithya</creatorcontrib><creatorcontrib>Niell, Harvey B.</creatorcontrib><creatorcontrib>Atkins, James N.</creatorcontrib><creatorcontrib>Akerley, Wallace</creatorcontrib><creatorcontrib>Green, Mark R.</creatorcontrib><creatorcontrib>Vokes, Everett E.</creatorcontrib><creatorcontrib>Cancer and Leukemia Group B</creatorcontrib><title>Treatment Outcomes of Different Prognostic Groups of Patients on Cancer and Leukemia Group B Trial 39801: Induction Chemotherapy Followed by Chemoradiotherapy Compared with Chemoradiotherapy Alone for Unresectable Stage III Non-small Cell Lung Cancer</title><title>Journal of thoracic oncology</title><addtitle>J Thorac Oncol</addtitle><description><![CDATA[In Cancer and Leukemia Group B 39801, we evaluated whether induction chemotherapy before concurrent chemoradiotherapy would result in improved survival and demonstrated no significant benefit from the addition of induction chemotherapy. The primary objective of this analysis was to dichotomize patients into prognostic groups using factors predictive of survival and to investigate whether induction chemotherapy was beneficial in either prognostic group. A Cox proportional hazard model was used to assess the impact on survival of the following factors: (≥70 versus <70 years), gender, race, stage (IIIB versus IIIA), hemoglobin (hgb) (<13 versus ≥13 g/dl), performance status (PS) (1 versus 0), weight loss (≥5% versus <5%), treatment arm, and the interaction between weight loss and hgb. Factors predictive of decreased survival were weight loss ≥5%, age ≥70 years, PS of 1, and hgb <13 g/dl (p < 0.05). Patients were classified as having ≥2 poor prognostic factors (n = 165) or ≤1 factor (n = 166). The hazard ratio (HR) for overall survival for the patients with ≥2 versus patients with ≤1 was 1.88 [95% confidence interval (CI), 1.49–2.37; p = <0.0001]; median survival times observed were 9 (95% CI, 8–11) and 18 (95% CI, 16–24) months, respectively. There was no significant difference in survival between treatment arms in patients with ≥2 factors (HR = 0.86, 95% CI, 0.63–1.17; p = 0.34) or ≤1 factor (HR = 0.97, 95% CI, 0.70–1.35; p = 0.87). There is no evidence that induction chemotherapy is beneficial in either prognostic group.]]></description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>CALGB</subject><subject>Carcinoma, Non-Small-Cell Lung - mortality</subject><subject>Carcinoma, Non-Small-Cell Lung - pathology</subject><subject>Carcinoma, Non-Small-Cell Lung - therapy</subject><subject>Chemoradiation</subject><subject>Clinical Trials as Topic</subject><subject>Combined Modality Therapy</subject><subject>Female</subject><subject>Humans</subject><subject>Induction chemotherapy</subject><subject>Locally advanced non-small cell lung cancer</subject><subject>Lung Neoplasms - mortality</subject><subject>Lung Neoplasms - pathology</subject><subject>Lung Neoplasms - therapy</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoplasm Staging</subject><subject>Prognosis</subject><subject>Prognostic factors</subject><subject>Proportional Hazards Models</subject><subject>Treatment Outcome</subject><issn>1556-0864</issn><issn>1556-1380</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFUluPEyEUnhiNu67-A2N48m1WmAtDfTBZq7vWNHYTu8-EgTMdXAYqMNv0r_sktZP1EqMvQPgunHP4suw5wecEz5pXH9erc9xiUkJJGGmLpi3LB9kpqWuak5Lhh9MZM1qdZE9C-IJxVeOKPc5OyIzWBS2q0-zb2oOIA9iIVmOUboCAXIfe6a4Df7i99m5jXYhaoivvxu0P-FpEncB0tmgurASPhFVoCeMtDFocmegtWnstDCpnDJPXaGHVKKM-SHoYXOzBi-0eXTpj3A4UavdHwAul79G5G7bCJ3SnY_8X_MI4C6hzHt1YDwFkFK0B9DmKDaDFYoE-OZuHQRiD5pCW5Wg3U8lPs0edMAGeTftZdnP5fj3_kC9XV4v5xTKXNcFlTqHGANDgStWKiaJjjIpOFAAz1rUNITWwtqoKqlgjOtbRSilZ1AzTpmDQ0PIse3P03Y7tAEqmwXlh-NbrQfg9d0Lz3xGre75xd7xoGlaxOhm8nAy8-zpCiHzQQaZuhAU3Bk4bimlRHIjVkSi9C8FDd_8IwfwQGp5Cw_8MTZK9-LXAn6IpJYnAjoSdMxF8uDXjDjzvQZjY_897ah7ShO90UgWZoiNBaZ8-iyun_23wHSVp61Q</recordid><startdate>200909</startdate><enddate>200909</enddate><creator>Stinchcombe, Thomas E.</creator><creator>Hodgson, Lydia</creator><creator>Herndon, James E.</creator><creator>Kelley, Michael J.</creator><creator>Cicchetti, M Giulia</creator><creator>Ramnath, Nithya</creator><creator>Niell, Harvey B.</creator><creator>Atkins, James N.</creator><creator>Akerley, Wallace</creator><creator>Green, Mark R.</creator><creator>Vokes, Everett E.</creator><general>Elsevier Inc</general><general>International Association for the Study of Lung Cancer</general><scope>6I.</scope><scope>AAFTH</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><scope>5PM</scope></search><sort><creationdate>200909</creationdate><title>Treatment Outcomes of Different Prognostic Groups of Patients on Cancer and Leukemia Group B Trial 39801: Induction Chemotherapy Followed by Chemoradiotherapy Compared with Chemoradiotherapy Alone for Unresectable Stage III Non-small Cell Lung Cancer</title><author>Stinchcombe, Thomas E. ; Hodgson, Lydia ; Herndon, James E. ; Kelley, Michael J. ; Cicchetti, M Giulia ; Ramnath, Nithya ; Niell, Harvey B. ; Atkins, James N. ; Akerley, Wallace ; Green, Mark R. ; Vokes, Everett E.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5103-6e50eee704d5d8a2f886afa2ee98fb7115e8b4426d87af8f64ddc25806728e763</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>CALGB</topic><topic>Carcinoma, Non-Small-Cell Lung - mortality</topic><topic>Carcinoma, Non-Small-Cell Lung - pathology</topic><topic>Carcinoma, Non-Small-Cell Lung - therapy</topic><topic>Chemoradiation</topic><topic>Clinical Trials as Topic</topic><topic>Combined Modality Therapy</topic><topic>Female</topic><topic>Humans</topic><topic>Induction chemotherapy</topic><topic>Locally advanced non-small cell lung cancer</topic><topic>Lung Neoplasms - mortality</topic><topic>Lung Neoplasms - pathology</topic><topic>Lung Neoplasms - therapy</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoplasm Staging</topic><topic>Prognosis</topic><topic>Prognostic factors</topic><topic>Proportional Hazards Models</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Stinchcombe, Thomas E.</creatorcontrib><creatorcontrib>Hodgson, Lydia</creatorcontrib><creatorcontrib>Herndon, James E.</creatorcontrib><creatorcontrib>Kelley, Michael J.</creatorcontrib><creatorcontrib>Cicchetti, M Giulia</creatorcontrib><creatorcontrib>Ramnath, Nithya</creatorcontrib><creatorcontrib>Niell, Harvey B.</creatorcontrib><creatorcontrib>Atkins, James N.</creatorcontrib><creatorcontrib>Akerley, Wallace</creatorcontrib><creatorcontrib>Green, Mark R.</creatorcontrib><creatorcontrib>Vokes, Everett E.</creatorcontrib><creatorcontrib>Cancer and Leukemia Group B</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</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><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of thoracic oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Stinchcombe, Thomas E.</au><au>Hodgson, Lydia</au><au>Herndon, James E.</au><au>Kelley, Michael J.</au><au>Cicchetti, M Giulia</au><au>Ramnath, Nithya</au><au>Niell, Harvey B.</au><au>Atkins, James N.</au><au>Akerley, Wallace</au><au>Green, Mark R.</au><au>Vokes, Everett E.</au><aucorp>Cancer and Leukemia Group B</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Treatment Outcomes of Different Prognostic Groups of Patients on Cancer and Leukemia Group B Trial 39801: Induction Chemotherapy Followed by Chemoradiotherapy Compared with Chemoradiotherapy Alone for Unresectable Stage III Non-small Cell Lung Cancer</atitle><jtitle>Journal of thoracic oncology</jtitle><addtitle>J Thorac Oncol</addtitle><date>2009-09</date><risdate>2009</risdate><volume>4</volume><issue>9</issue><spage>1117</spage><epage>1125</epage><pages>1117-1125</pages><issn>1556-0864</issn><eissn>1556-1380</eissn><abstract><![CDATA[In Cancer and Leukemia Group B 39801, we evaluated whether induction chemotherapy before concurrent chemoradiotherapy would result in improved survival and demonstrated no significant benefit from the addition of induction chemotherapy. The primary objective of this analysis was to dichotomize patients into prognostic groups using factors predictive of survival and to investigate whether induction chemotherapy was beneficial in either prognostic group. A Cox proportional hazard model was used to assess the impact on survival of the following factors: (≥70 versus <70 years), gender, race, stage (IIIB versus IIIA), hemoglobin (hgb) (<13 versus ≥13 g/dl), performance status (PS) (1 versus 0), weight loss (≥5% versus <5%), treatment arm, and the interaction between weight loss and hgb. Factors predictive of decreased survival were weight loss ≥5%, age ≥70 years, PS of 1, and hgb <13 g/dl (p < 0.05). Patients were classified as having ≥2 poor prognostic factors (n = 165) or ≤1 factor (n = 166). The hazard ratio (HR) for overall survival for the patients with ≥2 versus patients with ≤1 was 1.88 [95% confidence interval (CI), 1.49–2.37; p = <0.0001]; median survival times observed were 9 (95% CI, 8–11) and 18 (95% CI, 16–24) months, respectively. There was no significant difference in survival between treatment arms in patients with ≥2 factors (HR = 0.86, 95% CI, 0.63–1.17; p = 0.34) or ≤1 factor (HR = 0.97, 95% CI, 0.70–1.35; p = 0.87). There is no evidence that induction chemotherapy is beneficial in either prognostic group.]]></abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>19652624</pmid><doi>10.1097/JTO.0b013e3181b27b33</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record>
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subjects	Adult Aged Aged, 80 and over CALGB Carcinoma, Non-Small-Cell Lung - mortality Carcinoma, Non-Small-Cell Lung - pathology Carcinoma, Non-Small-Cell Lung - therapy Chemoradiation Clinical Trials as Topic Combined Modality Therapy Female Humans Induction chemotherapy Locally advanced non-small cell lung cancer Lung Neoplasms - mortality Lung Neoplasms - pathology Lung Neoplasms - therapy Male Middle Aged Neoplasm Staging Prognosis Prognostic factors Proportional Hazards Models Treatment Outcome
title	Treatment Outcomes of Different Prognostic Groups of Patients on Cancer and Leukemia Group B Trial 39801: Induction Chemotherapy Followed by Chemoradiotherapy Compared with Chemoradiotherapy Alone for Unresectable Stage III Non-small Cell Lung Cancer
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