Publication:
Significance of overall concurrent chemoradiotherapy duration on survival outcomes of stage IIIB/C non-small-cell lung carcinoma patients: analysis of 956 patients

dc.contributor.coauthorTopkan, Erkan
dc.contributor.coauthorÖzdemir, Yurday
dc.contributor.coauthorKüçük, Ahmet
dc.contributor.coauthorBesen, Ali Ayberk
dc.contributor.coauthorMertsoylu, Hüseyin
dc.contributor.coauthorSezer, Ahmet
dc.contributor.departmentSchool of Medicine
dc.contributor.kuauthorSelek, Uğur
dc.contributor.schoolcollegeinstituteSCHOOL OF MEDICINE
dc.date.accessioned2024-11-09T13:08:22Z
dc.date.issued2019
dc.description.abstractBackground: to investigate the detrimental effects of prolonged overall radiotherapy duration (ORTD) on survival outcomes of stage IIIB/C NSCLC patients treated with concurrent chemoradiotherapy (C-CRT) Methods: the study cohort consisted of 956 patients who underwent C-CRT for stage IIIB/C NSCLC. Primary endpoint was the association between the ORTD and overall survival (OS) with locoregional progression-free survival (LRPFS) and PFS comprising the secondary endpoints. Receiver operating characteristic (ROC) curve analysis was utilized for accessibility of the cut-off that interacts with survival outcomes. Multivariate Cox model was utilized to identify the independent associates of survival outcomes. Results: the ROC curve analysis exhibited significance at 49 days of ORTD cut-off that dichotomized patients into ORTD<50 versus ORTD50 days groups for OS [area under the curve (AUC): 82.8%; sensitivity: 81.1%; specificity: 74.8%], LRPFS (AUC: 91.9%; sensitivity: 90.6%; specificity: 76.3%), and PFS (AUC: 76.1%; sensitivity: 72.4%; specificity: 68.2%), respectively. Accordingly, ORTD50 days group had significantly shorter median OS (P<0.001), LRPFS (P<0.001), and PFS (P<0.001); and 10-year actuarial locoregional control (P<0.001) and distant metastases-free (P<0.011) rates than the ORTD<50 days group. The ORTD retained its significant association with survival outcomes at multivariate analyses independent of the other favorable covariates (p<0.001, for OS, LRPFS, and PFS): Stage IIIB disease (versus IIIC), lymph node bulk <2 cm (versus 2 cm), and 2–3 chemotherapy cycles (versus 1). The higher sensitivity for LRPFS (90.6%) than PFS (72.4%) on ROC curve analysis suggested the prolonged ORTD-induced decrements in locoregional control rates as the major cause of the poor survival outcomes. Conclusions: longer ORTD beyond 50 days was associated with significantly poorer OS, LRPFS and PFS outcomes, where reduced locoregional control rates appeared to be the main causative.
dc.description.fulltextYES
dc.description.indexedbyWOS
dc.description.indexedbyScopus
dc.description.indexedbyPubMed
dc.description.issue7
dc.description.openaccessYES
dc.description.publisherscopeInternational
dc.description.sponsoredbyTubitakEuN/A
dc.description.sponsorshipN/A
dc.description.versionPublisher version
dc.description.volume14
dc.identifier.doi10.1371/journal.pone.0218627
dc.identifier.embargoNO
dc.identifier.filenameinventorynoIR01641
dc.identifier.issn1932-6203
dc.identifier.quartileQ2
dc.identifier.scopus2-s2.0-85069855309
dc.identifier.urihttps://doi.org/10.1371/journal.pone.0218627
dc.identifier.wos484974100008
dc.keywordsTreatment time
dc.keywordsRadiation-therapy
dc.keywordsLocal-control
dc.keywordsPhase-III
dc.keywordsSequential chemoradiotherapy
dc.keywordsRetrospective analysis
dc.keywordsThoracic radiotherapy
dc.keywordsChemotherapy worth
dc.keywordsAdvanced head
dc.keywordsCancer
dc.language.isoeng
dc.publisherPublic Library of Science
dc.relation.grantnoNA
dc.relation.ispartofPLOS One
dc.relation.urihttp://cdm21054.contentdm.oclc.org/cdm/ref/collection/IR/id/8264
dc.subjectScience and technology
dc.titleSignificance of overall concurrent chemoradiotherapy duration on survival outcomes of stage IIIB/C non-small-cell lung carcinoma patients: analysis of 956 patients
dc.typeJournal Article
dspace.entity.typePublication
local.contributor.kuauthorSelek, Uğur
local.publication.orgunit1SCHOOL OF MEDICINE
local.publication.orgunit2School of Medicine
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relation.isOrgUnitOfPublication.latestForDiscoveryd02929e1-2a70-44f0-ae17-7819f587bedd
relation.isParentOrgUnitOfPublication17f2dc8e-6e54-4fa8-b5e0-d6415123a93e
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