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Tohru Okada



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    P2.18 - Treatment of Locoregional Disease - NSCLC (ID 191)

    • Event: WCLC 2019
    • Type: Poster Viewing in the Exhibit Hall
    • Track: Treatment of Locoregional Disease - NSCLC
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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      P2.18-18 - Impact of Combined Evaluation Using Tumor Volume and Metastatic Nodal Extent in Stage III NSCLC Treated with CRT (ID 310)

      10:15 - 18:15  |  Author(s): Tohru Okada

      • Abstract
      • Slides

      Background

      Chemoradiotherapy (CRT) is the standard treatment for patients with unresectable stage III non-small cell lung cancer (NSCLC). In those, gross tumor volume (GTV) and number of metastatic nodal stations were proposed as possible prognostic factors, while TNM stage classification (stage IIIA vs. stage IIIB/IIIC) did not show significant prognostic impact. However, these evidences remain controversial. The aim of this study was to investigate the prognostic impact of GTV and metastatic nodal extent.

      Method

      We retrospectively reviewed stage III NSCLC patients treated with CRT at our institution between October 2005 and December 2018. Simplified GTV (sGTV) was calculated by oval volume formula. We confirmed statistically significant association between sGTV and standard GTV as previous preparation. Metastatic nodal extent was divided into limited nodal extent (≤ND2a) (defined as "LN") or extensive nodal extent (>ND2a)(defined as "EN"). Prognostic impact of sGTV and metastatic nodal extent was evaluated by univariate and multivariate analysis.

      Result

      58 patients were enrolled in this study. Median progression-free survival (PFS) of all patients were 9.0 months. In univariate analysis, patients with sGTV>90cm3 had shorter PFS compared to those with sGTV≤90cm3 (median PFS: 6.7 vs. 11.7, p=0.03). Further, patients with sGTV>90cm3 and EN showed poorer PFS (HR 3.3; 95% CI,1.40-7.87; p<0.01) and OS (HR 3.3, 95% CI: 1.18-9.32, p<0.01) in univariate analysis. Multivariate analysis also showed an independent poor prognosis in patients with sGTV>90cm3 and EN (adjusted HR of PFS: 3.6, 95% CI: 1.49-8.71, p<0.01, adjusted HR of OS 4.1, 95% CI: 1.37-12.6, p=0.01).

      Conclusion

      Combined evaluation using sGTV and metastatic nodal extent can be a useful stratified factor for clinical trial in patients with stage III NSCLC.

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