Prognostic impact of VEGF and VEGF receptor 1 (FLT1) expression in patients irradiated for stage II/III non-small cell lung cancer (NSCLC).
OBJECTIVE
The prognostic value of the tumor expression of vascular endothelial growth factor (VEGF) and VEGF receptor 1 (FLT1) is still unclear. This study investigated the impact of tumor expression of VEGF and FLT1 on outcomes in 61 patients irradiated for stage II/III non-small cell lung cancer (NSCLC).


METHODS
The impact of tumor VEGF and FLT expression and twelve additional potential prognostic factors on locoregional control (LC), metastases-free survival (MFS), and overall survival (OS) were retrospectively evaluated. These factors included age, gender, performance status, histology, histological grade, T-category, N-category, surgery, chemotherapy, pack-years, smoking during radiotherapy, and hemoglobin levels during radiotherapy.


RESULTS
On univariate analysis, improved LC was associated with lower T-category (p = 0.046), lower N-category (p = 0.047), and not smoking during radiotherapy (p = 0.012). VEGF (p = 0.26) and FLT1 expression (p = 0.70) had no significant impact. On multivariate analysis, lower N-category (p = 0.037) maintained significance; not smoking during radiotherapy was almost significant (p = 0.052). On univariate analysis, improved MFS was associated with lower T-category (p = 0.034) and lower N-category (p = 0.027), and almost with hemoglobin >or= 12 g/dl during radiotherapy (p = 0.053). VEGF (p = 0.80) and FLT1 expression (p = 0.61) had no significant impact. On multivariate analysis, lower N-category (p = 0.040) maintained significance. On univariate analysis, improved OS was associated with lower T-category (p = 0.028), lower N-category (p = 0.003), not smoking during radiotherapy (p = 0.047), and hemoglobin levels >or= 12 g/dl during radiotherapy (p = 0.019). VEGF (p = 0.59) and FLT1 expression (p = 0.85) had no significant impact. On multivariate analysis, lower N-category (p = 0.011) maintained significance.


CONCLUSIONS
Tumor expression of VEGF and FLT1 appear to have no significant impact on LC, MFS, or OS in patients irradiated for NSCLC.
Rades
Dirk
D
Department of Radiation Oncology, University of Lübeck, Germany. Rades.Dirk@gmx.net
Setter
Cornelia
C
Dunst
Juergen
J
Dahl
Olav
O
Schild
Steven E
SE
Noack
Frank
F
D000230:Adenocarcinoma / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis*; D001707:Biopsy, Needle; D018287:Carcinoma, Large Cell / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy* / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D018450:Disease Progression; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D008168:Lung / Q000473:pathology; D008175:Lung Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011013:Pneumonectomy; D011379:Prognosis; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D042461:Vascular Endothelial Growth Factor A / Q000032:analysis*; D040281:Vascular Endothelial Growth Factor Receptor-1 / Q000032:analysis*
D014408:Biomarkers, Tumor; D042461:Vascular Endothelial Growth Factor A; D040281:Vascular Endothelial Growth Factor Receptor-1