title: Time to treatment in patients with stage III non-small cell lung cancer.
abstract: OBJECTIVE
  To determine whether time to treatment (TTT) has an effect on overall survival (OS) in patients with unresectable or medically inoperable Stage III non-small cell lung cancer (NSCLC) and whether patient or treatment factors are associated with TTT.
  
  
  METHODS
  Included in the study were 237 consecutive patients with Stage III NSCLC treated at University of Michigan Hospital (UM) or the Veterans Affairs Ann Arbor Healthcare System (VA). Patients were treated with either palliative or definitive radiotherapy and radiotherapy alone (n = 106) or either sequential (n = 69) or concurrent chemoradiation (n = 62). The primary endpoint was OS.
  
  
  RESULTS
  Median follow-up was 69 months, and median TTT was 57 days. On univariate analysis, the risk of death did not increase significantly with longer TTT (p = 0.093). However, subset analysis showed that there was a higher risk of death with longer TTT in patients who survived >or= 5 years (p = 0.029). Younger age (p = 0.027), male sex (p = 0.013), lower Karnofsky Performance Score (KPS) (p = 0.002), and treatment at the VA (p = 0.001) were significantly associated with longer TTT. However, on multivariate analysis, only lower KPS remained significantly associated with longer TTT (p = 0.003).
  
  
  CONCLUSIONS
  Time to treatment is significantly associated with OS in patients with Stage III NSCLC who lived longer than 5 years, although it is not a significant factor in Stage III patients as a whole. Lower KPS is associated with longer TTT.
authors.affiliation: Department of Radiation Oncology, University of Michigan Medical Center, Ann Arbor, MI 48109, USA.
authors.forename: Li
authors.initials: L
authors.lastname: Wang
authors.forename: Candace R
authors.initials: CR
authors.lastname: Correa
authors.forename: James A
authors.initials: JA
authors.lastname: Hayman
authors.forename: Lujun
authors.initials: L
authors.lastname: Zhao
authors.forename: Kemp
authors.initials: K
authors.lastname: Cease
authors.forename: Dean
authors.initials: D
authors.lastname: Brenner
authors.forename: Doug
authors.initials: D
authors.lastname: Arenberg
authors.forename: Jeffery
authors.initials: J
authors.lastname: Curtis
authors.forename: Gregory P
authors.initials: GP
authors.lastname: Kalemkerian
authors.forename: Feng-Ming
authors.initials: FM
authors.lastname: Kong
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D018287:Carcinoma, Large Cell / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006768:Hospitals, Federal; D006801:Humans; D017567:Karnofsky Performance Status; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D011880:Radiotherapy Planning, Computer-Assisted; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D016019:Survival Analysis; D013997:Time Factors; D014481:United States