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- Title
The effect of non-small cell lung cancer histology on survival as measured by the graded prognostic assessment in patients with brain metastases treated by hypofractionated stereotactic radiotherapy.
- Authors
Liang-Hua Ma; Guang Li; Hong-Wei Zhang; Zhi-Yu Wang; Jun Dang; Shuo Zhang; Lei Yao; Ma, Liang-Hua; Li, Guang; Zhang, Hong-Wei; Wang, Zhi-Yu; Dang, Jun; Zhang, Shuo; Yao, Lei
- Abstract
<bold>Background: </bold>The purpose of this study was to investigate the impact of histology on survival stratified by the Graded Prognostic Assessment (GPA) for non-small cell lung cancer (NSCLC) in a group of selected patients treated recently.<bold>Methods: </bold>A total of 171 NSCLC patients with brain metastases treated by hypofractionated stereotactic radiotherapy with or without whole-brain radiotherapy between 2001 and 2011 were included. The GPA score was calculated for each patient. Tumor histologies were categorized into adenocarcinoma (ADCA) and non-ADCA. Median survival time (MST, in months) was calculated using the Kaplan-Meier method. The log-rank test was used to determine statistical differences.<bold>Results: </bold>MSTs by histology were: ADCA 15 (n = 92) and non-ADCA 10 (n = 79) (p < 0.001). For all patients, the MSTs by GPA score were: GPA 3.5-4, 24; GPA 2.5-3, 15; GPA 1.5-2, 9 and GPA 0-1, 6 (p < 0.001). The histology of ADCA showed a statistically significant higher MST than non-ADCA for patients with GPA 2.5-4. For GPA 2.5-3, MSTs were: ADCA 18, non-ADCA 10 (p = 0.007); for GPA 3.5-4, MSTs were: ADCA 30, non-ADCA 17 (p = 0.046). For GPA 0-2, MSTs did not differ significantly by histology. For GPA 0-1, MSTs were: ADCA 8, non-ADCA 4 (p = 0.146); GPA 1.5-2, MSTs were: ADCA 10, non-ADCA 8 (p = 0.291). We further found that non-ADCA in upper GPA class (3.5-4) had similar survival with ADCA in lower GPA class (2.5-3) (MSTs were 17 and 18, respectively, p = 0.775). This phenomenon also happened between patients of non-ADCA in upper GPA class (2.5-3) and those of ADCA in lower GPA class (1.5-2) (MSTs were both 10, p = 0.724).<bold>Conclusions: </bold>We confirmed that the histology of NSCLC had effect on the GPA in these selected patients treated recently. ADCA showed a statistically significant higher MST than non-ADCA with GPA 2.5-4. The non-ADCA in upper GPA classes (3.5-4 and 2.5-3) had similar survival to ADCA in lower GPA classes (2.5-3 and 1.5-2, respectively). The histology as a new factor should be added to the original GPA for NSCLC.
- Subjects
BRAIN metastasis; BRAIN cancer patients; STEREOTACTIC radiotherapy; NON-small-cell lung carcinoma; ADENOCARCINOMA; PROGNOSIS; CANCER-related mortality; CANCER radiotherapy; ONCOLOGIC surgery; BRAIN tumors; CANCER; COMPARATIVE studies; LONGITUDINAL method; LUNG cancer; LUNG tumors; RESEARCH methodology; MEDICAL cooperation; RADIATION doses; RADIOSURGERY; RADIOTHERAPY; RESEARCH; SQUAMOUS cell carcinoma; SURVIVAL; EVALUATION research; TUMOR grading
- Publication
Radiation Oncology, 2016, Vol 11, p1
- ISSN
1748-717X
- Publication type
journal article
- DOI
10.1186/s13014-016-0667-x