Selection of patients for stereotactic body radiation therapy (SBRT) or (bi)lobectomy (L) for the treatment of cT1-T2N0M0 NSCLC by the risk of node involvement using readily available preoperative factors
| العنوان: | Selection of patients for stereotactic body radiation therapy (SBRT) or (bi)lobectomy (L) for the treatment of cT1-T2N0M0 NSCLC by the risk of node involvement using readily available preoperative factors |
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| المؤلفون: | John C. Flickinger, Lacey J. McIntosh, Ferian Lou, Karl Uy, Mark Maxfield, Suhail M. Ali, Jennifer Baima, Debra Maddox, John M. Varlotto, Molly Griffin, Paulo J. Oliveira, Rick Voland, William V. Walsh, Christine Hebert, Thomas J. Fitzgerald, Isabel Cristina Martins Emmerick, Malcolm M. DeCamp |
| المصدر: | Journal of Clinical Oncology. 37:e20055-e20055 |
| بيانات النشر: | American Society of Clinical Oncology (ASCO), 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Cancer Research, medicine.medical_specialty, Oncology, Stereotactic body radiation therapy, business.industry, Node (networking), medicine, Stereotactic body radiation, Radiology, Non small cell, business, Selection (genetic algorithm) |
| الوصف: | e20055 Background: Currently it is not known whether certain patients with early-stage non-small cell lung cancer(NSCLC) would be better served with stereotactic body radiation (SBRT) or surgery. The purpose of our investigation is to see if patients who are at higher risk of node involvement based upon pre-operative factors would be preferentially served with (bi)Lobectomy(L). Methods: The NCDB was queried for the years 2004-2014 to find patients with cT1-T2N0M0 NSCLC (excluding lepidic adenocarcinoma and their variants) < 5cm treated via L or SBRT(N = 16,722). Recursive partition analysis was used in the L group to develop high, medium, and low risk node involvement groups in those patients having complete node assessment (10 or more nodes examined) by American College of Surgeons commission on cancer quality care measures(ACOS coc), N = 83,890. The L and SBRT groups were then propensity matched based upon factors associated with OS to assess whether there was an OS benefit for either the L or SBRT treatments by node risk category. OS was calculated by log-rank testing. Results: The high, medium, and low risk categories had an average risk for node involvement of 20.12, 11.3, and 4.57%, respectively. The low risk group was defined as tumors < 21mm for all squamous cell carcinomas(SQ) and adenocarcinoma(AD) in the right upper lobe only. High risk categories were associated tumors > 21 mm in the RUL in white Hispanics; and ages < 60yr old for SQ, large cell ca, and NSCLC-NOS; and > 21mm with non-RUL location and < 55yr old. OS was significantly better in patients treated by L for the high, medium, and low risk groups with all p-values of < 0.0001. Conclusions: When patients undergo a complete lymph node dissection by the ACOScoc quality measures and have (bi)lobectomy, their OS is superior to patients undergoing SBRT whether they are at high, low or medium risk of lymph node involvement. |
| تدمد: | 1527-7755 0732-183X |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_________::29c97e13f43eb0df51167ab4e5955cce https://doi.org/10.1200/jco.2019.37.15_suppl.e20055 |
| رقم الأكسشن: | edsair.doi...........29c97e13f43eb0df51167ab4e5955cce |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15277755 0732183X |
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