Histology significantly affects recurrence and survival following SBRT for early stage non-small cell lung cancer. 2018

Michael J Baine, and Vivek Verma, and Caitlin A Schonewolf, and Chi Lin, and Charles B Simone
Department of Radiation Oncology, Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE, USA.

Contrary to prevailing notions of uniform efficacy regarding stereotactic body radiation therapy (SBRT) for early-stage non-small cell lung cancer (NSCLC), a recent report has indicated increased risk of local failure for squamous cell carcinoma (SCC). As those data have not been corroborated by other studies, we performed a multi-institutional analysis to evaluate the influence of histology on post-SBRT outcomes. Records from 152 consecutive patients who received SBRT for primary early-stage NSCLC at two academic medical centers were retrospectively assessed. Primary comparison was between SCC and adenocarcinoma. Patient outcomes including actuarial recurrences and overall survival were calculated using the Kaplan-Meier method. Univariable and multivariable logistic regression analyses addressed associated factors. At a median follow-up of 44 months, patients with SCC had an increased risk of local, (hazard ratio (HR) (95% confidence interval (CI)): 1.69 (1.05-2.73), p = 0.032), regional (HR (95% CI): 2.03 (1.24-3.33), p = 0.005), and distant failure (HR (95% CI): 1.71 (1.06-2.77), p = 0.036). Median times to local (32 m vs 50m, p = 0.023), regional (26 m vs 50 m, p = 0.011), and distant (26 m vs 50 m, p = 0.024) failure were all significantly reduced in SCC histology. SCC histology was also independently associated with an increased risk for death (HR: 1.80 (1.10-2.94), p = 0.019) and had a 5-yr overall survival of 26%, versus 41% for adenocarcinoma (p = 0.016). This multi-institutional analysis corroborates that SCC histology is independently predictive for local, regional, and distant recurrence and worse overall survival. Future data are needed to determine if treatment paradigms should differ by histology for early stage NSCLC.

UI MeSH Term Description Entries
D008168 Lung Either of the pair of organs occupying the cavity of the thorax that effect the aeration of the blood. Lungs
D008175 Lung Neoplasms Tumors or cancer of the LUNG. Cancer of Lung,Lung Cancer,Pulmonary Cancer,Pulmonary Neoplasms,Cancer of the Lung,Neoplasms, Lung,Neoplasms, Pulmonary,Cancer, Lung,Cancer, Pulmonary,Cancers, Lung,Cancers, Pulmonary,Lung Cancers,Lung Neoplasm,Neoplasm, Lung,Neoplasm, Pulmonary,Pulmonary Cancers,Pulmonary Neoplasm
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009364 Neoplasm Recurrence, Local The local recurrence of a neoplasm following treatment. It arises from microscopic cells of the original neoplasm that have escaped therapeutic intervention and later become clinically visible at the original site. Local Neoplasm Recurrence,Local Neoplasm Recurrences,Locoregional Neoplasm Recurrence,Neoplasm Recurrence, Locoregional,Neoplasm Recurrences, Local,Recurrence, Local Neoplasm,Recurrence, Locoregional Neoplasm,Recurrences, Local Neoplasm,Locoregional Neoplasm Recurrences,Neoplasm Recurrences, Locoregional,Recurrences, Locoregional Neoplasm
D009367 Neoplasm Staging Methods which attempt to express in replicable terms the extent of the neoplasm in the patient. Cancer Staging,Staging, Neoplasm,Tumor Staging,TNM Classification,TNM Staging,TNM Staging System,Classification, TNM,Classifications, TNM,Staging System, TNM,Staging Systems, TNM,Staging, Cancer,Staging, TNM,Staging, Tumor,System, TNM Staging,Systems, TNM Staging,TNM Classifications,TNM Staging Systems
D002289 Carcinoma, Non-Small-Cell Lung A heterogeneous aggregate of at least three distinct histological types of lung cancer, including SQUAMOUS CELL CARCINOMA; ADENOCARCINOMA; and LARGE CELL CARCINOMA. They are dealt with collectively because of their shared treatment strategy. Carcinoma, Non-Small Cell Lung,Non-Small Cell Lung Cancer,Non-Small Cell Lung Carcinoma,Non-Small-Cell Lung Carcinoma,Nonsmall Cell Lung Cancer,Carcinoma, Non Small Cell Lung,Carcinomas, Non-Small-Cell Lung,Lung Carcinoma, Non-Small-Cell,Lung Carcinomas, Non-Small-Cell,Non Small Cell Lung Carcinoma,Non-Small-Cell Lung Carcinomas
D005260 Female Females
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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