| Inoperable early stage non-small cell lung cancer: Comorbidity, patterns of care and survival. | |
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MedLine Citation:
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PMID: 20801544 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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PURPOSE: To evaluate comorbidities, patterns of care and outcomes for patients with inoperable stage I and II non-small cell lung cancer (NSCLC). MATERIALS AND METHODS: Patients diagnosed with stage I or II NSCLC in British Columbia between 1996 and 2005 who did not undergo primary surgery and were referred for oncology assessment were identified in a retrospective analysis. Baseline comorbidity and pulmonary function data for patients treated with curative radiotherapy (CurRT; biologically effective dose [BED]>58 Gy(10)) were abstracted by chart review. Kaplan-Meier and Cox regression were used to determine factors associated with overall survival (OS) and cause-specific survival (CSS) based on treatment group [no radiotherapy (NoRT), palliative radiotherapy (PallRT), or CurRT]. RESULTS: Of 1043 patients identified, approximately 1/3 received CurRT, and these patients had better performance status and lower stage disease than the other groups. There was a high prevalence of comorbid conditions in the CurRT group; 90% of CurRT patients had an age-adjusted Charlson comorbidity index (CCI) score ≥5. CurRT patients had a median survival 1-year longer than patients treated with PallRT or NoRT (p<0.0001). In CurRT patients, CCI was predictive of OS (HR 1.1 per point CCI increase; p=0.044), but not CSS. Patients receiving PallRT with a BED>50 Gy(10) had significantly longer OS than those receiving PallRT of ≤50 Gy(10) (p<0.0001). CONCLUSIONS: Treatment of medically inoperable early stage NSCLC patients with CurRT is associated with a significantly longer survival, and for these patients CCI is a significant predictor of OS. For patients treated with PallRT, higher doses of palliative thoracic RT is associated with improved OS. |
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Authors:
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S L Smith; D Palma; T Parhar; C S Alexander; E S Wai |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Lung cancer (Amsterdam, Netherlands) Volume: 72 ISSN: 1872-8332 ISO Abbreviation: Lung Cancer Publication Date: 2011 Apr |
Date Detail:
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Created Date: 2011-03-07 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8800805 Medline TA: Lung Cancer Country: Ireland |
Other Details:
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Languages: eng Pagination: 39-44 Citation Subset: IM |
Copyright Information:
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Copyright © 2010 Elsevier Ireland Ltd. All rights reserved. |
Affiliation:
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Radiation Therapy Program, British Columbia Cancer Agency, Vancouver Island Centre, 410 Lee Avenue, Victoria, British Columbia V8R 6V5, Canada. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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