National Multi-Center Observational Retrospective Study to Understand Treatment Patterns and Outcomes for Stage III Non-Small Cell Lung Cancer Patients in Turkey: Turkish Society for Radiation Oncology Study, STONE Trial


Onal C., DEMİRAL A. N. , ATALAR B., YALMAN D., Dagoglu N., HÜRMÜZ P., ...More

UHOD-ULUSLARARASI HEMATOLOJI-ONKOLOJI DERGISI, vol.32, no.1, pp.23-34, 2022 (Peer-Reviewed Journal) identifier identifier

  • Publication Type: Article / Article
  • Volume: 32 Issue: 1
  • Publication Date: 2022
  • Doi Number: 10.4999/uhod.225876
  • Journal Name: UHOD-ULUSLARARASI HEMATOLOJI-ONKOLOJI DERGISI
  • Journal Indexes: Science Citation Index Expanded, Scopus, Academic Search Premier, EMBASE, TR DİZİN (ULAKBİM)
  • Page Numbers: pp.23-34
  • Keywords: Lung cancer, Stage III, Treatment patterns, Chemotherapy, Radiotherapy, TNM CLASSIFICATION, OPEN-LABEL, CHEMORADIOTHERAPY, CHEMOTHERAPY, MANAGEMENT, PROPOSALS, GROUPINGS, NIVOLUMAB, SURVIVAL, REVISION

Abstract

This study investigated treatment patterns and outcomes in patients with inoperable stage III non-small cell lung cancer (NSCLC) treated with radiotherapy (RT) in Turkey. We included 492 patients with stage III NSCLC in this multi-center retrospective study. Pa-tient demographics, clinical characteristics, and clinical treatment patterns from the time of the initial diagnosis to disease progression were recorded. Additionally, the prognostic factors predicting overall survival (OS) and progression-free survival (PFS) were analyzed. For the initial treatment, 429 patients (89.2%) received chemotherapy and RT, whereas 53 patients (10.8%) were treated only with RT. The first disease progression occurred in 288 patients (58.4%) at 9.3 months (median) after the initial treatment, and 64.6% re-ceived treatment after first progression. The second disease progression occurred in 30 patients, and 20 patients (66.7%) received treatment. Median OS and PFS were 27.0 months and 13.4 months, respectively. Age (p< 0.001), stage (p= 0.04), poor performance score (PS) (p= 0.03) and RT doses (p= 0.002) were independent predictors for OS and PFS in our multivariate analysis. Additional significant predictors for OS in the multivariate analysis were gender (p= 0.004), treatment period (0.02), and irradiation technique (p= 0.02). Disease progression occurred in nearly 58% of the patients, and one-third of these patients remained untreated during the disease progression. These findings indicate a need for additional treatment options in patients with unresectable stage III NSCLC with high-risk features, namely older age, stage IIIB disease, poor PS, and lower RT doses.