Wos İndeksli Açık & Kapalı Erişimli Yayınlar

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    Low Prognostic Nutritional Index Predicts Poor Clinical Outcomes in Patients with Stage IIIB Non-small-cell Lung Carcinoma Undergoing Chemoradiotherapy
    (2020) Ozdemir, Yurday; Topkan, Erkan; Mertsoylu, Huseyin; Selek, Ugur; 0000-0002-1932-9784; 0000-0001-8120-7123; 0000-0002-2218-2074; 32214853; M-9530-2014; AAG-2213-2021; AAG-5629-2021
    Purpose: To investigate the prognostic utility of the prognostic nutritional index (PNI) in stage IIIB non-small-cell lung carcinoma (NSCLC) patients undergoing concurrent chemoradiotherapy (CRT). Methods: A total of 358 stage IIIB NSCLC patients who received a total dose of 60-66 Gy (2 Gy/fraction) radiotherapy and >= 1 cycle(s) of platinum-based chemotherapy were analyzed. The receiver operating curve analysis was utilized to identify the optimal PNI cut-off value demonstrating a significant connection with the overall survival (OS), locoregional progression-free survival (LRPFS), and progression-free survival (PFS). Results: At a median follow-up time of 22.5 months (range: 2.4-123.5), 30.2% and 14% of the patients were still alive and free of disease progression, respectively.The median OS, LRPFS, and PFS were 25.2 [95% confidence interval (CI): 36.3-46.6 months], 15.4 (95% CI: 26.6-35.3 months), and 10.7 (95% CI: 36.8-69.9 months), individually, for the whole study accomplice. The ROC analysis revealed an optimum rounded cut-off that associated meaningfully with each of the OS [area under the curve (AUC): 84.1%; sensitivity: 75.9%;72.4% specificity], LRPFS (AUC: 92.4%; sensitivity: 87.9%; 85.1% specificity), and PFS (AUC: 80.1%; sensitivity: 73.7%; 71.6% specificity) at a value of 40.5. Comparative analyses revealed that the patients presenting with PNI <= 40.5 had significantly inferior OS (16.8 vs 36.7; P<0.001), LRPFS (11.5 vs 19.5; P<0.001), and PFS (8.6 vs 13.6; P<0.001) outcomes compared to patients with PNI>40.5. In univariate analyses, lower T-stage (1-2 vs 3-4; P< 0.001), lower N-stage (N2 vs N3; P< 0.001), anemia status (absent vs present; P< 0.001), weight loss status (<5% vs >= 5%; P< 0.001), and PM group (<= 40.5 vs >40.5; P<0.001) were the factors found to be associated with OS, LRPFS and PFS results. The results of multivariate analysis exhibited that the PM was independently associated with each of the OS (P<0.001), LRPFS (P<0.001), and PFS (P<0.001) outcomes. Conclusion: The pretreatment PNI appears to be a robust novel prognostic factor that stratifies patients with stage IIIB NSCLC into two significantly distinct survival groups after CRT.
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    Concurrent chemoradiotherapy with weekly carboplatin and paclitaxel may be a feasible option in inoperable stage III non-small cell lung cancer: a single center experience
    (2019) Calikusu, Zuleyha; Sedef, Ali Murat; Saltaoglu, Pinar
    Purpose: Concurrent chemoradiotherapy (CCRT) is a standard treatment for patients with unresectable stage III non-small cell lung cancer (NSCLC). An optimal chemotherapy regimen with concurrent thoracic radiotherapy is not known. In this study, we investigated the efficacy and toxicity of CCRT with carboplatin [area under curve (AUC) 2] and paclitaxel (80 mg/m(2)) during CCRT. Materials and Methods: We performed a retrospective survival analysis using medical records of 40 patients with inoperable stage III NSCLC that were treated with concurrent chemoradiotherapy with carboplatin-paclitaxel (AUC 2, 60 mg/m2). Results: The most common histopathology was adenocarcinoma, which was diagnosed in 18 patients (45%). There were 12 stage IIIA patients (30%) and 28 stage IIIB patients (70%). The median follow-up time was 22.5 months [95% confidence interval (CI), 2.9-72.2]. Median disease-free survival (DFS) and overall survival (OS) were 22.5 months (95% CI, 18.1-27.0) and 53.5 months (95% CI, 23.5-82.8). Grade 3-4 hematological and non-hematological toxicities were seen in 8 (20%) and 5 (12.5%) patients, respectively. Conclusion: This study showed that CCRT with weekly carboplatin-paclitaxel provides similar outcomes to cases in the literature and the regimen seems to be feasible with a low rate of grade 3-4 toxicity during CCRT of non operable stage III NSCLC. Keywords: Carboplatin, non-small cell lung cancer, chemoradiotherapy, paclitaxel