Care of patients with non-small-cell lung cancer stage III - The Central European real-world experience

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F27283933%3A_____%2F20%3A00008056" target="_blank" >RIV/27283933:_____/20:00008056 - isvavai.cz</a>

Výsledek na webu

<a href="https://content.sciendo.com/view/journals/raon/54/2/article-p209.xml" target="_blank" >https://content.sciendo.com/view/journals/raon/54/2/article-p209.xml</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.2478/raon-2020-0026" target="_blank" >10.2478/raon-2020-0026</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Care of patients with non-small-cell lung cancer stage III - The Central European real-world experience

Popis výsledku v původním jazyce

Background: Management of locally advanced (stage III) non-small cell lung cancer is complex and affected by regional specificities. The aim of the present study was to determine diagnostic procedures, treatment modalities and outcome of patients with NSCLC stage III in the real-world setting in Central European countries and to define areas for future improvements. Methods: This multicentre, prospective and non-interventional study determined the diagnostic and therapeutic procedures of consecutive patients with NSCLC stage III (UICC7). Data were collected in a web-based registry and centrally analysed. Results: The total study population comprised 583 patients from 16 centres of 7 countries with the following characteristics: 32% females, 7% never-smokers; ECOG performance status 0, 1, 2 and 3 in 25%, 58%, 12% and 5%, respectively; 21% prior weight loss; 53% squamous cell carcinoma, 38% adenocarcinoma, 6% NSCLC not otherwise specified, 3% others; 10% EGFR mutations. Staging procedures included chest X-ray (97% of patients), chest CT (96%) plus abdominal CT/US (67%/27%), PET-CT (27%), brain CT or MRI (20%), and bone scan (15%). Bronchoscopy was done in 89%, EBUS with biopsy in 13%, and CT-guided biopsy in 9% of patients. Stages IIIA and IIIB were diagnosed in 55% and 45% of patients, respectively. N2/N3 nodes were diagnosed in 352/133 (60%/23%) and pathologically confirmed in 172 (29%) of patients, mostly during surgery. Treatments were surgery in 23%, thoracic radiotherapy in 54% and chemotherapy in 80% of patients. The majority of patients (56%) were treated by combined modalities. Surgery plus chemotherapy with or without radiotherapy was administered to 118 (20%) patients. Definitive chemoradiotherapy (without surgery) was administered to 200 (34%) patients with concurrent chemoradiotherapy in 54 (9%) patients. Chemotherapy only was given to 150 (26%) patients. At a median follow-up of 30 months, median survival and progression-free survival times were 17 and 11 months, respectively. Multivariate analyses revealed longer survival times for stage IIIA, females, PS 0 or 1, no weight loss, and pathological verification of mediastinal lymph nodes. Patients undergoing surgery or combined modality therapy had longer survival with patients receiving tri-modality therapy achieving longest survival. Conclusion: The real-world study demonstrated a broad heterogeneity in the diagnostic and therapeutic management of patients with locally advanced NSCLC in Central European countries. The study confirmed well known prognostic factors and better survival outcome for patients who received combined modality therapies. Future improvements should focus on increasing the rates of PET-CT staging, brain imaging prior to treatment, and invasive staging of mediastinal lymph nodes.

Název v anglickém jazyce

Care of patients with non-small-cell lung cancer stage III - The Central European real-world experience

Popis výsledku anglicky

Background: Management of locally advanced (stage III) non-small cell lung cancer is complex and affected by regional specificities. The aim of the present study was to determine diagnostic procedures, treatment modalities and outcome of patients with NSCLC stage III in the real-world setting in Central European countries and to define areas for future improvements. Methods: This multicentre, prospective and non-interventional study determined the diagnostic and therapeutic procedures of consecutive patients with NSCLC stage III (UICC7). Data were collected in a web-based registry and centrally analysed. Results: The total study population comprised 583 patients from 16 centres of 7 countries with the following characteristics: 32% females, 7% never-smokers; ECOG performance status 0, 1, 2 and 3 in 25%, 58%, 12% and 5%, respectively; 21% prior weight loss; 53% squamous cell carcinoma, 38% adenocarcinoma, 6% NSCLC not otherwise specified, 3% others; 10% EGFR mutations. Staging procedures included chest X-ray (97% of patients), chest CT (96%) plus abdominal CT/US (67%/27%), PET-CT (27%), brain CT or MRI (20%), and bone scan (15%). Bronchoscopy was done in 89%, EBUS with biopsy in 13%, and CT-guided biopsy in 9% of patients. Stages IIIA and IIIB were diagnosed in 55% and 45% of patients, respectively. N2/N3 nodes were diagnosed in 352/133 (60%/23%) and pathologically confirmed in 172 (29%) of patients, mostly during surgery. Treatments were surgery in 23%, thoracic radiotherapy in 54% and chemotherapy in 80% of patients. The majority of patients (56%) were treated by combined modalities. Surgery plus chemotherapy with or without radiotherapy was administered to 118 (20%) patients. Definitive chemoradiotherapy (without surgery) was administered to 200 (34%) patients with concurrent chemoradiotherapy in 54 (9%) patients. Chemotherapy only was given to 150 (26%) patients. At a median follow-up of 30 months, median survival and progression-free survival times were 17 and 11 months, respectively. Multivariate analyses revealed longer survival times for stage IIIA, females, PS 0 or 1, no weight loss, and pathological verification of mediastinal lymph nodes. Patients undergoing surgery or combined modality therapy had longer survival with patients receiving tri-modality therapy achieving longest survival. Conclusion: The real-world study demonstrated a broad heterogeneity in the diagnostic and therapeutic management of patients with locally advanced NSCLC in Central European countries. The study confirmed well known prognostic factors and better survival outcome for patients who received combined modality therapies. Future improvements should focus on increasing the rates of PET-CT staging, brain imaging prior to treatment, and invasive staging of mediastinal lymph nodes.

Druh

O - Ostatní výsledky

CEP obor

—

OECD FORD obor

30204 - Oncology

Projekt

—

Návaznosti

V - Vyzkumna aktivita podporovana z jinych verejnych zdroju

Rok uplatnění

2020

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů