Factors affecting survival time after recurrence of non-small-cell lung cancer treated with concurrent chemoradiotherapy.
OBJECTIVE
Dose-fractionation schedules of palliative or salvage radiotherapy (RT) for recurrence of non-small-cell lung cancer (NSCLC) are various because they highly depend on patient prognosis. For optimal selection of dose-fractionation schedules, factors affecting survival time after recurrence were examined.


METHODS
From 1992 to 2005, 115 patients with stage III NSCLC received curative-intent concurrent chemoradiotherapy (CCRT). Among these patients, 74 underwent recurrence and were reviewed. Evaluated factors were age at recurrence, gender, initial stage, histological subtype, initial radiation-field size, recurrent patterns (locoregional alone vs. distant ± locoregional), time to recurrence (≤6 vs. >6 months), and treatment for recurrence (chemotherapy, RT).


RESULTS
Median follow-up time after recurrence was 7 (range 0-59) months. One- and 2-year overall survival rates after recurrence were 28 and 11%, respectively. Based on multivariate analysis, time to recurrence (p = 0.0001) and administration of chemotherapy for recurrence (p = 0.0190) were the independently significant factors.


CONCLUSIONS
Early recurrence was the most significant factor for survival after post-CCRT recurrence of NSCLC. Administration of chemotherapy for recurrence was also a significant factor, whereas RT for recurrence was not significant. When RT was given to patients with post-CCRT recurrence of NSCLC, dose-fractionated schedules should be determined considering these factors.
Department of Radiation Oncology, National Hospital Organization Shikoku Cancer Center, Kou-160, Minamiumemoto-Machi, Matsuyama, Ehime 791-0280, Japan. yhamamot@shikoku-cc.go.jp
Yasushi
Y
Hamamoto
Masaaki
M
Kataoka
Naoyuki
N
Nogami
Toshiyuki
T
Kozuki
Yuka
Y
Kato
Shuichi
S
Shinohara
Tetsu
T
Shinkai
D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology / Q000628:therapy*; D059248:Chemoradiotherapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D011879:Radiotherapy Dosage; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome
D000970:Antineoplastic Agents