Dataset Information

Early body weight loss during concurrent chemo-radiotherapy for non-small cell lung cancer.

ABSTRACT:

Background and purpose

Radiation-esophagitis and weight loss are frequently observed toxicities in patients treated with concurrent chemo-radiotherapy (CT-RT) for non-small cell lung cancer (NSCLC) and might be related. The purpose was to investigate whether weight loss already starts early after initiation of CT-RT and precedes radiation-esophagitis.

Materials and methods

In a retrospective cohort, weight and esophagitis grade ?2 were assessed during the first weeks of (CT-)RT in patients treated with concurrent (n?=?102) or sequential (n?=?92) therapy. In a prospective validation study, data on body weight, esophagitis grade ?2, nutritional intake and muscle strength were obtained before, during and following CT-RT.

Results

In the retrospective cohort, early weight loss was observed in concurrently treated patients (p?=?0.002), independent of esophagitis???grade 2. Early weight loss was also observed in the prospective cohort (p?=?0.003) and was not accompanied by decreases in nutritional intake. In addition lower limb muscle strength rapidly declined (p?=?0.042). In the later weeks of treatment, further body weight loss occurred (p?ConclusionsWeight loss during concurrent CT-RT for NSCLC starts early and prior to onset of esophagitis, requiring timely and intense nutritional rehabilitation.

SUBMITTER: Op den Kamp CM

PROVIDER: S-EPMC4053563 | biostudies-literature | 2014 Jun

REPOSITORIES: biostudies-literature

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Publications

Early body weight loss during concurrent chemo-radiotherapy for non-small cell lung cancer.

Op den Kamp Céline M H CM De Ruysscher Dirk K M DK van den Heuvel Marieke M Elferink Meike M Houben Ruud M A RM Oberije Cary J G CJ Bootsma Gerben P GP Geraedts Wiel H WH Pitz Cordula C M CC Langen Ramon C RC Wouters Emiel F M EF Schols Annemie M W J AM Dingemans Anne-Marie C AM

Journal of cachexia, sarcopenia and muscle 20140123 2

<h4>Background and purpose</h4>Radiation-esophagitis and weight loss are frequently observed toxicities in patients treated with concurrent chemo-radiotherapy (CT-RT) for non-small cell lung cancer (NSCLC) and might be related. The purpose was to investigate whether weight loss already starts early after initiation of CT-RT and precedes radiation-esophagitis.<h4>Materials and methods</h4>In a retrospective cohort, weight and esophagitis grade ≥2 were assessed during the first weeks of (CT-)RT in ...[more]

PMID: 24452446

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Project description:ObjectivesTo compare patterns of care and overall survival (OS) between stereotactic body radiotherapy (SBRT) and percutaneous local tumor ablation (LTA) for non-surgically managed early-stage non-small-cell lung cancer (NSCLC).Materials and methodsThe National Cancer Database (NCDB) was queried from 2004 to 2014 for adults with non-metastatic, node-negative invasive adenocarcinoma or squamous cell carcinoma of the lung with primary tumor size ≤5.0 cm who did not undergo surgery or chemotherapy and received SBRT or LTA. Patterns of care were assessed with multivariate logistic regression. After propensity-score weighting with generalized boosted regression, OS was assessed with univariate and doubly-robust multivariate Cox regression.ResultsOf 15,792 patients, 14,651 (93%) received SBRT and 1141 (7%) received LTA. Increasing age (OR 1.01, p = .035), treatment at an academic institution (OR 2.94, p < .001), increasing tumor size (OR 1.05, p < .001), and more recent year of diagnosis (OR 1.43, p < .001) were predictive of treatment with SBRT, whereas comorbidities (OR 0.74, p = .003) and treatment at a high-volume facility (OR 0.05, p < .001) were predictive for LTA. At a median follow-up of 26.2 months, SBRT was associated with improved OS relative to LTA within a propensity-score weighted doubly-robust multivariate analysis (HR 0.71, p < .001). On weighted subgroup analyses, improved OS was observed with SBRT for tumor sizes >2.0 cm (HR 0.72, p < .001) and for those treated at high-volume facilities (HR 0.71, p < .001). No OS difference was found with SBRT or LTA in tumor sizes ≤2.0 cm (HR 0.90, p = .227).ConclusionWithin the NCDB, SBRT was more commonly utilized and was associated with improved OS when compared to percutaneous LTA for patients with non-surgically managed early-stage NSCLC. Patients with small tumor volumes likely represent an appropriate population for future prospective randomized comparisons between SBRT and LTA.

Dataset Information

Early body weight loss during concurrent chemo-radiotherapy for non-small cell lung cancer.

Background and purpose

Materials and methods

Results

Publications

Early body weight loss during concurrent chemo-radiotherapy for non-small cell lung cancer.

Similar Datasets

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