The impact of timing adjuvant therapy on disease-free survival among patients with stage iib-iiia non-small cell lung cancer receiving platinum- based treatment

Year 2023, , 639 - 644, 30.09.2023

Muslih Ürün , Yasin Sezgin , Emre Uysal

https://doi.org/10.18663/tjcl.1344051

Abstract

Aim: We aimed to investigate the relationship between time to adjuvant therapy and disease-free survival in patients with
non-small cell lung cancer who underwent curative surgical resection and received adjuvant therapy.
Material and Methods: In our study, stage IIB-IIIA patients who underwent curative surgical resection and received adjuvant therapy between 2010 and 2020 were retrospectively evaluated. They were categorized as those who started treatment before and after 6 weeks, and the time to radiologic recurrence was calculated.
Results: A total of 89 patients were included. Adjuvant treatment was started within 6 weeks after surgery in 52 patients and after 6 weeks in 37 patients. Disease-free survival was statistically significantly lower in patients who started treatment after 6 weeks (p=0.014). In addition, ECOG performance score of 0 and starting adjuvant treatment before 6 weeks were found to be independent prognostic factors in multivariate analysis (p=0.001, p=0.045).
Conclusions: In patients with NSCLC who underwent curative resection and planned adjuvant treatment, starting treatment after 6 weeks shortened disease-free survival. According to our results, it is recommended to start treatment before 6 weeks.

Keywords

Lung cancer, adjuvant, chemotherapy, disease-free survival

Adjuvant platin bazlı tedavi verilen evre ııb-ıııa küçük hücreli dışı akciğer kanseri hastalarında adjuvant tedaviye kadar geçen sürenin hastalıksız sağkalıma etkisi

Abstract

Amaç: küratif cerrahi rezeksiyon geçiren ve adjuvan tedavi verilen küçük hücreli dışı akciğer kanseri hastalarında tedaviye kadar geçen sürenin hastalıksız sağ kalımla ilişkisi
Gereç ve yöntemler: Çalışmamıza 2010-2020 yılları arasında küratif cerrahi rezeksiyon geçirmiş adjuvan tedavi alan evre IIB-IIIA hastalar alındı. Tedaviye 6 haftadan önce ve sonra başlayanlar olarak kategorize edilip radyolojik nükse kadar geçen zaman hesaplandı.
Bulgular:Toplam 89 hasta alındı. 52 hastaya tedavş 6 haftadan önce başlanmış 37 hastaya ise 6 haftdan sonra başlamış. Tedaviye 6 haftadan sonra başlanan hastalarda hastalıksız sağ kalım istatistiksel olarak anlamlı derece de daha düşüktü.
Sonuçlar: küratif rezeksiyon uygulanan adjuvan tedavi verilen küçük hücreli dışı akciğer kanseri hastalarında tedaviye 6 haftadan sonra başlamak hastalıksız sağ kalımı kısaltmıştır. Tedaviye mümkünse 6 haftadan önce başlanmalıdır

Keywords

akciğer kanseri, adjuvan, kemoterapi, hastalıksız sağkalım

Supporting Institution

destekleyen kurum yok

References

• Sung, H., et al., Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a cancer journal for clinicians, 2021. 71(3): p. 209-249.
• Howlader, N., et al., The effect of advances in lung-cancer treatment on population mortality. New England Journal of Medicine, 2020. 383(7): p. 640-649.
• Siegel, R.L., et al., Cancer statistics, 2021. Ca Cancer J Clin, 2021. 71(1): p. 7-33.
• Rami-Porta, R., et al., The IASLC lung cancer staging project: proposals for the revisions of the T descriptors in the forthcoming eighth edition of the TNM classification for lung cancer. Journal of Thoracic Oncology, 2015. 10(7): p. 990-1003.
• Pignon, J.-P., et al., Lung adjuvant cisplatin evaluation: a pooled analysis by the LACE Collaborative Group, in Database of Abstracts of Reviews of Effects (DARE): Quality-Assessed Reviews [Internet]. 2008, Centre for Reviews and Dissemination (UK).
• Pisters, K.M., et al., Cancer Care Ontario and American Society of Clinical Oncology adjuvant chemotherapy and adjuvant radiation therapy for stages I-IIIA resectable non–small-cell lung cancer guideline. Journal of clinical oncology, 2007. 25(34): p. 5506-5518.
• Network, N.C.C., Non-Small Cell Lung Cancer (version 2.2020) https://www. nccn. org/professionals/physician_gls/pdf/nscl. pdf. Accessed January, 2020. 18.
• Winton, T., et al., Vinorelbine plus cisplatin vs. observation in resected non–small-cell lung cancer. New England Journal of Medicine, 2005. 352(25): p. 2589-2597.
• Douillard, J.-Y., et al., Adjuvant vinorelbine plus cisplatin versus observation in patients with completely resected stage IB–IIIA non-small-cell lung cancer (Adjuvant Navelbine International Trialist Association [ANITA]): a randomised controlled trial. The lancet oncology, 2006. 7(9): p. 719-727.
• Kozower, B.D., et al., STS database risk models: predictors of mortality and major morbidity for lung cancer resection. The Annals of thoracic surgery, 2010. 90(3): p. 875-883.
• Teh, E., et al., What is the extent of the advantage of video- assisted thoracoscopic surgical resection over thoracotomy in terms of delivery of adjuvant chemotherapy following non- small-cell lung cancer resection? Interactive cardiovascular and thoracic surgery, 2014. 19(4): p. 656-660.
• Nachiappan, S., et al., The impact of adjuvant chemotherapy timing on overall survival following colorectal cancer resection. European Journal of Surgical Oncology (EJSO), 2015. 41(12): p. 1636-1644.
• Chavez-MacGregor, M., et al., Delayed initiation of adjuvant chemotherapy among patients with breast cancer. JAMA oncology, 2016. 2(3): p. 322-329.
• Irie, M., et al., Risk factors for short-term outcomes after thoracoscopic lobectomy for lung cancer. European Respiratory Journal, 2016. 48(2): p. 495-503.
• Postmus, P., et al., Early and locally advanced non-small-cell lung cancer (NSCLC): ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of oncology, 2017. 28: p. iv1-iv21.
• Szejniuk, W.M., et al., Adjuvant platinum-based chemotherapy in non-small cell lung cancer: The role of relative dose- intensity and treatment delay. Cancer Treatment and Research Communications, 2021. 27: p. 100318.
• Ramsden, K., J. Laskin, and C. Ho, Adjuvant chemotherapy in resected stage II non-small cell lung cancer: evaluating the impact of dose intensity and time to treatment. Clinical Oncology, 2015. 27(7): p. 394-400.
• Booth, C.M., et al., Time to adjuvant chemotherapy and survival in non–small cell lung cancer: A population‐based study. Cancer, 2013. 119(6): p. 1243-1250.
• Salazar, M.C., et al., Association of delayed adjuvant chemotherapy with survival after lung cancer surgery. JAMA oncology, 2017. 3(5): p. 610-619.
• Wang, B.-Y., et al., Impact on survival on interval between surgery and adjuvant chemotherapy in completely resected stage IB-IIIA lung cancer. PloS one, 2016. 11(11): p. e0163809.