Prognostic significance of weight gain during definitive chemoradiotherapy for locally advanced non-small-cell lung cancer

David J. Sher, Benjamin T. Gielda, Michael J. Liptay, William H. Warren, Marta Batus, Mary Jo Fidler, Shalini Garg, Philip Bonomi

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: The successful treatment of locally advanced non-small-cell lung cancer (NSCLC) with chemoradiotherapy (CRT) is still compromised by poor locoregional and distant control rates. Given the morbidity associated with treatment, it is critical to determine clinical prognostic factors to risk stratify patients before and after aggressive therapy. This study aimed to discern the prognostic value of weight gain during CRT in patients with locally advanced NSCLC. Patients and Methods: This was a retrospective analysis of 92 patients treated with definitive split-course CRT between 2004 and 2010 at Rush University Medical Center. Weight gain was defined as a weight change greater than the highest quartile of change between the start and finish of CRT (4.5 lb). Overall survival (OS), locoregional progression-free survival (PFS), and distant metastasis-free survival (DMFS) were determined using Kaplan-Meier analysis, and the cumulative incidences of locoregional and distant recurrence were calculated. Cox regression (multivariate analysis) was used to determine independent predictors of OS. Results: With a median follow-up of 50 months for surviving patients, the median, 3- and 5-year OS probabilities were 25 months, 37%, and 29%, respectively. The 3-year cumulative risks of locoregional and distant metastases were 51% and 64%. Patients who experienced weight gain were significantly more likely to survive (3-year OS, 55% vs. 31%; P =.04) and prolonged DMFS resulted. Weight gain was the only significant predictor of survival on multivariate analysis. Conclusions: Weight gain during split-course CRT was associated with superior OS and DMFS. The presence of weight gain may have utility in risk stratification after CRT as well as in identifying novel treatment approaches for patients with locally advanced NSCLC.

Original languageEnglish (US)
Pages (from-to)370-375
Number of pages6
JournalClinical Lung Cancer
Volume14
Issue number4
DOIs
StatePublished - Jul 1 2013

Fingerprint

Chemoradiotherapy
Non-Small Cell Lung Carcinoma
Weight Gain
Survival
Neoplasm Metastasis
Multivariate Analysis
Kaplan-Meier Estimate
Therapeutics
Disease-Free Survival
Regression Analysis
Morbidity
Weights and Measures
Recurrence
Incidence

Keywords

  • Chemoradiotherapy
  • NSCLC
  • Prognostic factors

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Pulmonary and Respiratory Medicine

Cite this

Prognostic significance of weight gain during definitive chemoradiotherapy for locally advanced non-small-cell lung cancer. / Sher, David J.; Gielda, Benjamin T.; Liptay, Michael J.; Warren, William H.; Batus, Marta; Fidler, Mary Jo; Garg, Shalini; Bonomi, Philip.

In: Clinical Lung Cancer, Vol. 14, No. 4, 01.07.2013, p. 370-375.

Research output: Contribution to journalArticle

Sher, David J. ; Gielda, Benjamin T. ; Liptay, Michael J. ; Warren, William H. ; Batus, Marta ; Fidler, Mary Jo ; Garg, Shalini ; Bonomi, Philip. / Prognostic significance of weight gain during definitive chemoradiotherapy for locally advanced non-small-cell lung cancer. In: Clinical Lung Cancer. 2013 ; Vol. 14, No. 4. pp. 370-375.
@article{c34ac2b2f7084104b00c280d2fb96558,
title = "Prognostic significance of weight gain during definitive chemoradiotherapy for locally advanced non-small-cell lung cancer",
abstract = "Background: The successful treatment of locally advanced non-small-cell lung cancer (NSCLC) with chemoradiotherapy (CRT) is still compromised by poor locoregional and distant control rates. Given the morbidity associated with treatment, it is critical to determine clinical prognostic factors to risk stratify patients before and after aggressive therapy. This study aimed to discern the prognostic value of weight gain during CRT in patients with locally advanced NSCLC. Patients and Methods: This was a retrospective analysis of 92 patients treated with definitive split-course CRT between 2004 and 2010 at Rush University Medical Center. Weight gain was defined as a weight change greater than the highest quartile of change between the start and finish of CRT (4.5 lb). Overall survival (OS), locoregional progression-free survival (PFS), and distant metastasis-free survival (DMFS) were determined using Kaplan-Meier analysis, and the cumulative incidences of locoregional and distant recurrence were calculated. Cox regression (multivariate analysis) was used to determine independent predictors of OS. Results: With a median follow-up of 50 months for surviving patients, the median, 3- and 5-year OS probabilities were 25 months, 37{\%}, and 29{\%}, respectively. The 3-year cumulative risks of locoregional and distant metastases were 51{\%} and 64{\%}. Patients who experienced weight gain were significantly more likely to survive (3-year OS, 55{\%} vs. 31{\%}; P =.04) and prolonged DMFS resulted. Weight gain was the only significant predictor of survival on multivariate analysis. Conclusions: Weight gain during split-course CRT was associated with superior OS and DMFS. The presence of weight gain may have utility in risk stratification after CRT as well as in identifying novel treatment approaches for patients with locally advanced NSCLC.",
keywords = "Chemoradiotherapy, NSCLC, Prognostic factors",
author = "Sher, {David J.} and Gielda, {Benjamin T.} and Liptay, {Michael J.} and Warren, {William H.} and Marta Batus and Fidler, {Mary Jo} and Shalini Garg and Philip Bonomi",
year = "2013",
month = "7",
day = "1",
doi = "10.1016/j.cllc.2012.10.009",
language = "English (US)",
volume = "14",
pages = "370--375",
journal = "Clinical Lung Cancer",
issn = "1525-7304",
publisher = "Elsevier",
number = "4",

}

TY - JOUR

T1 - Prognostic significance of weight gain during definitive chemoradiotherapy for locally advanced non-small-cell lung cancer

AU - Sher, David J.

AU - Gielda, Benjamin T.

AU - Liptay, Michael J.

AU - Warren, William H.

AU - Batus, Marta

AU - Fidler, Mary Jo

AU - Garg, Shalini

AU - Bonomi, Philip

PY - 2013/7/1

Y1 - 2013/7/1

N2 - Background: The successful treatment of locally advanced non-small-cell lung cancer (NSCLC) with chemoradiotherapy (CRT) is still compromised by poor locoregional and distant control rates. Given the morbidity associated with treatment, it is critical to determine clinical prognostic factors to risk stratify patients before and after aggressive therapy. This study aimed to discern the prognostic value of weight gain during CRT in patients with locally advanced NSCLC. Patients and Methods: This was a retrospective analysis of 92 patients treated with definitive split-course CRT between 2004 and 2010 at Rush University Medical Center. Weight gain was defined as a weight change greater than the highest quartile of change between the start and finish of CRT (4.5 lb). Overall survival (OS), locoregional progression-free survival (PFS), and distant metastasis-free survival (DMFS) were determined using Kaplan-Meier analysis, and the cumulative incidences of locoregional and distant recurrence were calculated. Cox regression (multivariate analysis) was used to determine independent predictors of OS. Results: With a median follow-up of 50 months for surviving patients, the median, 3- and 5-year OS probabilities were 25 months, 37%, and 29%, respectively. The 3-year cumulative risks of locoregional and distant metastases were 51% and 64%. Patients who experienced weight gain were significantly more likely to survive (3-year OS, 55% vs. 31%; P =.04) and prolonged DMFS resulted. Weight gain was the only significant predictor of survival on multivariate analysis. Conclusions: Weight gain during split-course CRT was associated with superior OS and DMFS. The presence of weight gain may have utility in risk stratification after CRT as well as in identifying novel treatment approaches for patients with locally advanced NSCLC.

AB - Background: The successful treatment of locally advanced non-small-cell lung cancer (NSCLC) with chemoradiotherapy (CRT) is still compromised by poor locoregional and distant control rates. Given the morbidity associated with treatment, it is critical to determine clinical prognostic factors to risk stratify patients before and after aggressive therapy. This study aimed to discern the prognostic value of weight gain during CRT in patients with locally advanced NSCLC. Patients and Methods: This was a retrospective analysis of 92 patients treated with definitive split-course CRT between 2004 and 2010 at Rush University Medical Center. Weight gain was defined as a weight change greater than the highest quartile of change between the start and finish of CRT (4.5 lb). Overall survival (OS), locoregional progression-free survival (PFS), and distant metastasis-free survival (DMFS) were determined using Kaplan-Meier analysis, and the cumulative incidences of locoregional and distant recurrence were calculated. Cox regression (multivariate analysis) was used to determine independent predictors of OS. Results: With a median follow-up of 50 months for surviving patients, the median, 3- and 5-year OS probabilities were 25 months, 37%, and 29%, respectively. The 3-year cumulative risks of locoregional and distant metastases were 51% and 64%. Patients who experienced weight gain were significantly more likely to survive (3-year OS, 55% vs. 31%; P =.04) and prolonged DMFS resulted. Weight gain was the only significant predictor of survival on multivariate analysis. Conclusions: Weight gain during split-course CRT was associated with superior OS and DMFS. The presence of weight gain may have utility in risk stratification after CRT as well as in identifying novel treatment approaches for patients with locally advanced NSCLC.

KW - Chemoradiotherapy

KW - NSCLC

KW - Prognostic factors

UR - http://www.scopus.com/inward/record.url?scp=84878788435&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84878788435&partnerID=8YFLogxK

U2 - 10.1016/j.cllc.2012.10.009

DO - 10.1016/j.cllc.2012.10.009

M3 - Article

C2 - 23260389

AN - SCOPUS:84878788435

VL - 14

SP - 370

EP - 375

JO - Clinical Lung Cancer

JF - Clinical Lung Cancer

SN - 1525-7304

IS - 4

ER -