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Treatment outcomes and prognostic factors in locally advanced non-small cell lung cancer – An experience from normal India


1 Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India
2 Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India
3 Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India

Correspondence Address:
Sushmita Pathy,
Room no 221, 2nd Floor, Department of Radiation Oncology, BRA-IRCH, All India Institute of Medical Sciences, New Delhi 110 029
India
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jcrt.jcrt_1855_20

Context: Chemoradiation is the standard of care in locally advanced non-small cell lung cancer (LA-NSCLC). Clinical presentation, disease course, and available treatment options are challenges to overcome. Little is known about the ideal timing and interaction of the two modalities, its relevance in day-to-day decision-making and the treatment outcome. Aims: The study evaluates the demographic profile, treatment pattern, outcome, and radiotherapy (RT) practice and patient care of LA-NSCLC at a tertiary cancer center. Setting and Design: This is a retrospective study from a tertiary cancer centre. Archives of patients of LA-NSCLC treated between June 2016 and June 2018 were included in our study. Materials and Methods: Clinical, demographic characteristics, treatment patterns, and outcomes were recorded. RT practice and patient care process including the integration of RT with other specialties, waiting time, and compliance to treatment were documented and analyzed. Statistical Analysis: Overall survival (OS) and progression-free survival (PFS) were the primary endpoints of the study. Log-rank test was used for univariate analysis for the factors on OS, and Cox's proportional hazards model was used for multivariate analysis for cofactors on OS. Results: Two hundred and thirty-two patients of lung cancer were treated during the study period. Fifty-four patients were squamous cell carcinoma, 108 were adenocarcinoma, and 12 were others. Out of 59 patients of LA-NSCLC, 34 underwent definitive chemoradiation. The median follow-up was 11 months (0.7–29), median overall treatment time was 44 days, median PFS was 8.9 months (range: 1.6–28.6), and median OS was 9.4 months (1.7–44.8). Time to start any oncological intervention was 1 month (0.1–4.3) and time to start RT was 2.1 months (0.1–5.4). Adherence to treatment was 91.2%. Age ≥65 and performance status ≥2 were significant for OS on univariate analysis and none on multivariate analysis. Conclusions: One-third of the cases of NSCLC present in LA stage and a third are suitable for definitive chemoradiation and only 20% undergo the planned treatment.


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