title: Swedish lung cancer radiation study group: predictive value of histology for radiotherapy response in patients with non-small cell lung cancer.
abstract: The aim of the present study was to evaluate the potential predictive value of histology in non-small cell lung cancer (NSCLC) treated with curatively intended radiotherapy. In a collaborative effort among all the Swedish Oncology Departments, clinical data were collected for 1146 patients with a diagnosed non-small cell lung cancer subjected to curatively intended irradiation (⩾50 Gy) during the years 1990 to 2000. The included patients were identified based on a manual search of all medical and radiation charts at the oncology departments from which the individual patient data were collected. Only patients who did not have a histological diagnosis date and death date/last follow-up date were excluded (n=141). Among the 1146 patients with non-small cell carcinoma eligible for analysis, 919 were diagnosed with either adenocarcinoma (n=323) or squamous cell carcinoma (n=596) and included in this study. The median survival for the 919 patients was 14.8 months, while the 5-year survival rate was 9.5%. Patients with adenocarcinoma had a significantly better overall survival compared with patients with squamous cell carcinoma (p=0.0062, log-rank test). When comparing different stages, this survival benefit was most pronounced for stages IIA-IIB (p<0.0001, log-rank test). The difference in survival between the two histological groups was statistically significant in a univariate Cox analysis (p=0.0063) as well as in two multivariate Cox analyses including demographic and treatment variables (p=0.037 and p=0.048, respectively). In this large population based retrospective study we describe for the first time that patients with adenocarcinoma have a better survival after curatively intended radiation therapy in comparison with squamous cell carcinoma patients, particularly those with clinical stages IIA-IIB.
authors: Department of Oncology, Uppsala University Hospital, Sweden.
authors: Georg
authors: G
authors: Holgersson
authors: Stefan
authors: S
authors: Bergström
authors: Michael
authors: M
authors: Bergqvist
authors: Jan
authors: J
authors: Nyman
authors: Even
authors: E
authors: Hoye
authors: Martin
authors: M
authors: Helsing
authors: Signe
authors: S
authors: Friesland
authors: Margareta
authors: M
authors: Holgersson
authors: Elisabet
authors: E
authors: Birath
authors: Simon
authors: S
authors: Ekman
authors: Thomas
authors: T
authors: Blystad
authors: Sven-Börje
authors: SB
authors: Ewers
authors: Charlotte
authors: C
authors: Mörth
authors: Britta
authors: B
authors: Löden
authors: Roger
authors: R
authors: Henriksson
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy*; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016019:Survival Analysis; D013548:Sweden