Outcomes after neoadjuvant or adjuvant chemotherapy for cT2-4N0-1 non-small cell lung cancer: A propensity-matched analysis

被引:32
作者
Brandt, Whitney S. [1 ]
Yan, Wanpu [1 ]
Zhou, Jian [1 ]
Tan, Kay See [2 ]
Montecalvo, Joseph [3 ]
Park, Bernard J. [1 ]
Adusumilli, Prasad S. [1 ]
Huang, James [1 ]
Bott, Matthew J. [1 ]
Rusch, Valerie W. [1 ]
Molena, Daniela [1 ]
Travis, William D. [3 ]
Kris, Mark G. [4 ]
Chaft, Jamie E. [4 ]
Jones, David R. [1 ]
机构
[1] Mem Sloan Kettering Canc Ctr, Dept Surg, Thorac Surg Serv, 1275 York Ave, New York, NY 10021 USA
[2] Mem Sloan Kettering Canc Ctr, Dept Epidemiol & Biostat, New York, NY 10021 USA
[3] Mem Sloan Kettering Canc Ctr, Dept Pathol, 1275 York Ave, New York, NY 10021 USA
[4] Mem Sloan Kettering Canc Ctr, Dept Med, Thorac Oncol Serv, 1275 York Ave, New York, NY 10021 USA
基金
美国国家卫生研究院;
关键词
non-small cell lung cancer; neoadjuvant chemotherapy; adjuvant chemotherapy; propensity-matched analysis; survival; VINORELBINE PLUS CISPLATIN; PHASE-III; SURGERY; PREDICTION; SURVIVAL; TRIAL; IB;
D O I
10.1016/j.jtcvs.2018.09.098
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: Comparative survival between neoadjuvant chemotherapy and adjuvant chemotherapy for patients with cT2-4N0-1M0 non-small cell lung cancer has not been extensively studied. Methods: Patients with cT2-4N0-1M0 non-small cell lung cancer who received platinum-based chemotherapy were retrospectively identified. Exclusion criteria included stage IV disease, induction radiotherapy, and targeted therapy. The primary end point was disease-free survival. Secondary end points were overall survival, chemotherapy tolerance, and ability of Response Evaluation Criteria In Solid Tumors response to predict survival. Survival was estimated using the Kaplan-Meier method, compared using the log-rank test and Cox proportional hazards models, and stratified using matched pairs after propensity score matching. Results: In total, 330 patients met the inclusion criteria (n = 92/group after propensity-score matching; median follow-up, 42 months). Five-year disease-free survival was 49% (95% confidence interval, 39-61) for neoadjuvant chemotherapy versus 48% (95% confidence interval, 38-61) for adjuvant chemotherapy (P = .70). On multivariable analysis, disease-free survival was not associated with neoadjuvant chemotherapy or adjuvant chemotherapy (hazard ratio, 1.1; 95% confidence interval, 0.64-1.90; P = .737), nor was overall survival (hazard ratio, 1.21; 95% confidence interval, 0.63-2.30; P = .572). The neoadjuvant chemotherapy group was more likely to receive full doses and cycles of chemotherapy (P = .014/0.005) and had fewer grade 3 or greater toxicities (P = .001). Response Evaluation Criteria In Solid Tumors response to neoadjuvant chemotherapy was associated with disease-free survival (P = .035); 15% of patients receiving neoadjuvant chemotherapy (14/92) had a major pathologic response. Conclusions: Timing of chemotherapy, before or after surgery, is not associated with an improvement in overall or disease-free survival among patients with cT2-4N0-1M0 non-small cell lung cancer who undergo complete surgical resection.
引用
收藏
页码:743 / +
页数:14
相关论文
共 28 条
[1]  
[Anonymous], CLIN PRACT GUID ONC
[2]  
[Anonymous], J THORAC CARDIOVASC
[3]   A clinical prediction model for prolonged air leak after pulmonary resection [J].
Attaar, Adam ;
Winger, Daniel G. ;
Luketich, James D. ;
Schuchert, Matthew J. ;
Sarkaria, Inderpal S. ;
Christie, Neil A. ;
Nason, Katie S. .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2017, 153 (03) :690-+
[4]   A Tutorial and Case Study in Propensity Score Analysis: An Application to Estimating the Effect of In-Hospital Smoking Cessation Counseling on Mortality [J].
Austin, Peter C. .
MULTIVARIATE BEHAVIORAL RESEARCH, 2011, 46 (01) :119-151
[5]   Optimal caliper widths for propensity-score matching when estimating differences in means and differences in proportions in observational studies [J].
Austin, Peter C. .
PHARMACEUTICAL STATISTICS, 2011, 10 (02) :150-161
[6]   Benefit of Adjuvant Chemotherapy After Resection of Stage II (T1-2N1M0) Non-Small Cell Lung Cancer in Elderly Patients [J].
Berry, Mark F. ;
Coleman, Brooke K. ;
Curtis, Lesley H. ;
Worni, Mathias ;
D'Amico, Thomas A. ;
Akushevich, Igor .
ANNALS OF SURGICAL ONCOLOGY, 2015, 22 (02) :642-648
[7]   CYCLOPHOSPHAMIDE, METHOTREXATE, AND FLUOROURACIL IN NODE-POSITIVE BREAST-CANCER - THE RESULTS OF 20 YEARS OF FOLLOW-UP [J].
BONADONNA, G ;
VALAGUSSA, P ;
MOLITERNI, A ;
ZAMBETTI, M ;
BRAMBILLA, C .
NEW ENGLAND JOURNAL OF MEDICINE, 1995, 332 (14) :901-906
[8]   Factors associated with distant recurrence following R0 lobectomy for pN0 lung adenocarcinoma [J].
Brandt, Whitney S. ;
Bouabdallah, Ilies ;
Tan, Kay See ;
Park, Bernard J. ;
Adusumilli, Prasad S. ;
Molena, Daniela ;
Bains, Manjit S. ;
Huang, James ;
Isbell, James M. ;
Bott, Matthew J. ;
Jones, David R. .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2018, 155 (03) :1212-+
[9]   Preoperative chemotherapy for non-small-cell lung cancer: a systematic review and meta-analysis of individual participant data [J].
Burdett, Sarah ;
Rydzewska, Larysa H. M. ;
Tierney, Jayne F. ;
Auperin, Anne ;
Le Pechoux, Cecile ;
Le Chevalier, Thierry ;
Pignon, Jean-Pierre .
LANCET, 2014, 383 (9928) :1561-1571
[10]   Adaptive Neoadjuvant Chemotherapy Guided by 18F-FDG PET in Resectable Non-Small Cell Lung Cancers: The NEOSCAN Trial [J].
Chaft, Jamie E. ;
Dunphy, Mark ;
Naidoo, Jarushka ;
Travis, William D. ;
Hellmann, Matthew ;
Woo, Kaitlin ;
Downey, Robert ;
Rusch, Valerie ;
Ginsberg, Michelle S. ;
Azzoli, Christopher G. ;
Kris, Mark G. .
JOURNAL OF THORACIC ONCOLOGY, 2016, 11 (04) :537-544