title: Subsets more likely to benefit from surgery or prophylactic cranial irradiation after chemoradiation for localized non-small-cell lung cancer.
abstract: After chemoradiation for localized non-small-cell lung cancer, surgery and prophylactic cranial irradiation (PCI) have been used as additional therapies. Less than a third of patients develop brain recurrences, or have local recurrence as their sole initial site of recurrence; these are groups that would benefit from PCI or surgery, respectively. Pretreatment identification of patients more likely to benefit from surgery or PCI would be useful. A retrospective analysis of 80 patients was performed to determine prognostic factors for such patterns of failure. Twenty-nine patients were subsequently selected for surgery in a nonrandomized manner. Seventeen patients had isolated local initial recurrence and 15 had brain recurrences. In multivariable analysis, female gender and elevated LDH were found to be risk factors for brain recurrence. In the subset with stage III disease (n = 76), squamous cell histology was a risk factor for isolated initial local recurrence in both univariable and multivariable analysis. It is possible to identify subsets that may show increased benefit from PCI or surgery.
authors.affiliation: London Regional Cancer Center, London, Ontario, Canada.
authors.forename: Bruce
authors.initials: B
authors.lastname: Keith
authors.forename: Mark
authors.initials: M
authors.lastname: Vincent
authors.forename: Larry
authors.initials: L
authors.lastname: Stitt
authors.forename: Anna
authors.initials: A
authors.lastname: Tomiak
authors.forename: Richard
authors.initials: R
authors.lastname: Malthaner
authors.forename: Edward
authors.initials: E
authors.lastname: Yu
authors.forename: Pauline
authors.initials: P
authors.lastname: Truong
authors.forename: Richard
authors.initials: R
authors.lastname: Inculet
authors.forename: Michael
authors.initials: M
authors.lastname: Lefcoe
authors.forename: A Rashid
authors.initials: AR
authors.lastname: Dar
authors.forename: Walter
authors.initials: W
authors.lastname: Kocha
authors.forename: Ian
authors.initials: I
authors.lastname: Craig
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000517:prevention & control / Q000556:secondary; D002289:Carcinoma, Non-Small-Cell Lung / Q000556:secondary / Q000628:therapy*; D003131:Combined Modality Therapy; D016371:Cranial Irradiation; D005260:Female; D006801:Humans; D007770:L-Lactate Dehydrogenase; D008175:Lung Neoplasms / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D011013:Pneumonectomy; D011379:Prognosis; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D007770:L-Lactate Dehydrogenase