دورية أكاديمية
The impact of pathologic staging of the hilar/mediastinal nodes on outcomes in patients with early-stage NSCLC receiving stereotactic body radiotherapy.
| العنوان: | The impact of pathologic staging of the hilar/mediastinal nodes on outcomes in patients with early-stage NSCLC receiving stereotactic body radiotherapy. |
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| المؤلفون: | Mullins BT; Department of Radiation Oncology, University of North Carolina Hospitals, Chapel Hill, NC, USA., Moore DT; Department of Radiation Oncology, University of North Carolina Hospitals, Chapel Hill, NC, USA.; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA., Rivera MP; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.; Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA., Marks LB; Department of Radiation Oncology, University of North Carolina Hospitals, Chapel Hill, NC, USA.; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA., Akulian J; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.; Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA., Pearlstein KA; Department of Radiation Oncology, University of North Carolina Hospitals, Chapel Hill, NC, USA.; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA., Wang K; Department of Radiation Oncology, University of North Carolina Hospitals, Chapel Hill, NC, USA.; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA., Burks AC; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.; Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA., Weiner AA; Department of Radiation Oncology, University of North Carolina Hospitals, Chapel Hill, NC, USA.; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. |
| المصدر: | Journal of thoracic disease [J Thorac Dis] 2021 Feb; Vol. 13 (2), pp. 1045-1054. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: AME Publishing Company Country of Publication: China NLM ID: 101533916 Publication Model: Print Cited Medium: Print ISSN: 2072-1439 (Print) Linking ISSN: 20721439 NLM ISO Abbreviation: J Thorac Dis Subsets: PubMed not MEDLINE |
| أسماء مطبوعة: | Publication: Hong Kong : AME Publishing Company Original Publication: Hong Kong : Pioneer Bioscience Pub. Co. |
| مستخلص: | Background: The importance of invasive mediastinal nodal staging in early-stage non-small cell lung cancer (NSCLC) in the PET/CT era is dependent on tumor factors that increase risk of nodal metastasis. At our institution, patients undergo biopsy via either CT-guidance (without nodal staging) or navigational bronchoscopy with endobronchial ultrasound transbronchial needle aspiration for nodal staging. This study aims to compare outcomes after stereotactic body radiotherapy (SBRT) stratified by receipt of invasive mediastinal nodal staging. Methods: In this retrospective study, records of all consecutive patients undergoing SBRT for early-stage NSCLC between 2010 and 2017 were analyzed. The association between time-to event outcomes (recurrence and survival) were evaluated with covariates of interest including tumor size, location, histology, smoking history, prior lung cancer history, radiation dose and receipt of nodal staging. Both univariable and multivariable analyses were used to examine these comparisons. Results: Overall, 158 patients were treated with SBRT. One hundred forty-nine out of one hundred fifty-eight patients (94%) underwent PET/CT staging, and all patients underwent tumor-directed biopsy. Seventy-nine patients underwent navigational bronchoscopy with nodal staging and 79 patients underwent CT-guided biopsy without nodal staging. Receipt of nodal staging was not associated with tumor size (P=0.35), yet was associated with central tumor location (P<0.001). There was no statistically significant association between receipt of nodal staging and time-to-event recurrence or survival outcomes; for example 3-year overall survival (OS) was 65% vs. 67% (P=0.65) and 3-year freedom from nodal failure was 84% vs. 69% (P=0.1) for those with and without nodal staging, respectively. Conclusions: Similar recurrence and survival outcomes were observed after SBRT regardless of receipt of invasive mediastinal nodal staging. Further prospective evaluation can help identify which patients might derive greatest benefit from invasive staging of the mediastinum in the PET/CT era. Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/jtd-20-2808). The authors have no conflicts of interest to declare. (2021 Journal of Thoracic Disease. All rights reserved.) |
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| فهرسة مساهمة: | Keywords: Non-small cell lung cancer (NSCLC); lung cancer; nodal staging; radiation therapy; stereotactic body radiotherapy (SBRT) |
| تواريخ الأحداث: | Date Created: 20210315 Latest Revision: 20220421 |
| رمز التحديث: | 20231215 |
| مُعرف محوري في PubMed: | PMC7947488 |
| DOI: | 10.21037/jtd-20-2808 |
| PMID: | 33717577 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 2072-1439 |
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| DOI: | 10.21037/jtd-20-2808 |