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Differential Relapse Patterns for Non-small Cell Lung Cancer Subtypes Adenocarcinoma and Squamous Cell Carcinoma: Implications for Radiation Oncology.
- Source :
-
Clinical oncology (Royal College of Radiologists (Great Britain)) [Clin Oncol (R Coll Radiol)] 2019 Oct; Vol. 31 (10), pp. 711-719. Date of Electronic Publication: 2019 Jul 24. - Publication Year :
- 2019
-
Abstract
- Aims: Curative-intent (radical) radiotherapy aims to control local disease and cure non-small cell lung cancer (NSCLC). The predominant subtypes of NSCLC are adenocarcinoma and squamous cell carcinoma (SCC). The radiotherapy paradigm offered to patients does not differ according to these two subtypes. Relapse patterns and disease control rates for adenocarcinoma and SCC treated with radical radiotherapy were determined.<br />Materials and Methods: A radical radiotherapy database covering the period from 2004 to June 2016 was examined to determine the first sites of relapse and the actuarial local and distant control rates.<br />Results: In total, 537 patients with known pathological subtype were treated over the period. In 39 (7%), the site of first relapse was uncertain. Of the remainder, 203 (41%) had adenocarcinoma and 295 (59%) had SCC. At a median follow-up of 16.4 months, 58% had relapsed. There was a difference in relapse patterns (chi-squared test P < 0.0005), with a higher rate of first relapse locally in SCC (42% of all patients versus 24%) and a higher rate of first relapse in the brain for adenocarcinoma (14% versus 3%). The actuarial local control rate was worse for SCC (hazard ratio 0.6, 95% confidence interval 0.5-0.9, P = 0.002). The brain metastasis-free survival was worse for adenocarcinoma (hazard ratio 4.1, 95% confidence interval 2.2-7.5, P < 0.0001).<br />Conclusion: There is a difference in relapse patterns between NSCLC histological subtypes, indicating that these are distinct entities. This may have implications for follow-up policy and strategies to improve disease control.<br /> (Copyright © 2019 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.)
- Subjects :
- Adenocarcinoma of Lung pathology
Aged
Brain Neoplasms secondary
Carcinoma, Non-Small-Cell Lung pathology
Carcinoma, Squamous Cell pathology
Female
Humans
Incidence
Lung Neoplasms pathology
Male
Neoplasm Recurrence, Local diagnosis
Neoplasm Staging
Prospective Studies
Radiation Oncology
Survival Rate
United Kingdom epidemiology
Adenocarcinoma of Lung radiotherapy
Brain Neoplasms radiotherapy
Carcinoma, Non-Small-Cell Lung radiotherapy
Carcinoma, Squamous Cell radiotherapy
Lung Neoplasms radiotherapy
Neoplasm Recurrence, Local epidemiology
Radiotherapy mortality
Subjects
Details
- Language :
- English
- ISSN :
- 1433-2981
- Volume :
- 31
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Clinical oncology (Royal College of Radiologists (Great Britain))
- Publication Type :
- Academic Journal
- Accession number :
- 31351746
- Full Text :
- https://doi.org/10.1016/j.clon.2019.07.008