Time to Treatment in Patients With Stage III Non-Small Cell Lung Cancer

Li Wang, Candace R. Correa, James A. Hayman, Lujun Zhao, Kemp Cease, Dean Brenner, Doug Arenberg, Jeffery Curtis, Gregory P. Kalemkerian, Feng Ming Kong

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Purpose: To determine whether time to treatment (TTT) has an effect on overall survival (OS) in patients with unresectable or medically inoperable Stage III non-small cell lung cancer (NSCLC) and whether patient or treatment factors are associated with TTT. Methods and Materials: Included in the study were 237 consecutive patients with Stage III NSCLC treated at University of Michigan Hospital (UM) or the Veterans Affairs Ann Arbor Healthcare System (VA). Patients were treated with either palliative or definitive radiotherapy and radiotherapy alone (n = 106) or either sequential (n = 69) or concurrent chemoradiation (n = 62). The primary endpoint was OS. Results: Median follow-up was 69 months, and median TTT was 57 days. On univariate analysis, the risk of death did not increase significantly with longer TTT (p = 0.093). However, subset analysis showed that there was a higher risk of death with longer TTT in patients who survived ≥ 5 years (p = 0.029). Younger age (p = 0.027), male sex (p = 0.013), lower Karnofsky Performance Score (KPS) (p = 0.002), and treatment at the VA (p = 0.001) were significantly associated with longer TTT. However, on multivariate analysis, only lower KPS remained significantly associated with longer TTT (p = 0.003). Conclusion: Time to treatment is significantly associated with OS in patients with Stage III NSCLC who lived longer than 5 years, although it is not a significant factor in Stage III patients as a whole. Lower KPS is associated with longer TTT.

Original languageEnglish (US)
Pages (from-to)790-795
Number of pages6
JournalInternational Journal of Radiation Oncology Biology Physics
Volume74
Issue number3
DOIs
StatePublished - Jul 1 2009

Fingerprint

Non-Small Cell Lung Carcinoma
lungs
cancer
Therapeutics
death
Survival
radiation therapy
Radiotherapy
Veterans
set theory
Multivariate Analysis
Delivery of Health Care

Keywords

  • Non-small cell lung cancer
  • Stage III
  • overall survival
  • time to treatment
  • treatment delay

ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

Wang, L., Correa, C. R., Hayman, J. A., Zhao, L., Cease, K., Brenner, D., ... Kong, F. M. (2009). Time to Treatment in Patients With Stage III Non-Small Cell Lung Cancer. International Journal of Radiation Oncology Biology Physics, 74(3), 790-795. https://doi.org/10.1016/j.ijrobp.2008.08.039

Time to Treatment in Patients With Stage III Non-Small Cell Lung Cancer. / Wang, Li; Correa, Candace R.; Hayman, James A.; Zhao, Lujun; Cease, Kemp; Brenner, Dean; Arenberg, Doug; Curtis, Jeffery; Kalemkerian, Gregory P.; Kong, Feng Ming.

In: International Journal of Radiation Oncology Biology Physics, Vol. 74, No. 3, 01.07.2009, p. 790-795.

Research output: Contribution to journalArticle

Wang, L, Correa, CR, Hayman, JA, Zhao, L, Cease, K, Brenner, D, Arenberg, D, Curtis, J, Kalemkerian, GP & Kong, FM 2009, 'Time to Treatment in Patients With Stage III Non-Small Cell Lung Cancer', International Journal of Radiation Oncology Biology Physics, vol. 74, no. 3, pp. 790-795. https://doi.org/10.1016/j.ijrobp.2008.08.039
Wang, Li ; Correa, Candace R. ; Hayman, James A. ; Zhao, Lujun ; Cease, Kemp ; Brenner, Dean ; Arenberg, Doug ; Curtis, Jeffery ; Kalemkerian, Gregory P. ; Kong, Feng Ming. / Time to Treatment in Patients With Stage III Non-Small Cell Lung Cancer. In: International Journal of Radiation Oncology Biology Physics. 2009 ; Vol. 74, No. 3. pp. 790-795.
@article{cff2d6a1811541cfbbc9960e8c88308d,
title = "Time to Treatment in Patients With Stage III Non-Small Cell Lung Cancer",
abstract = "Purpose: To determine whether time to treatment (TTT) has an effect on overall survival (OS) in patients with unresectable or medically inoperable Stage III non-small cell lung cancer (NSCLC) and whether patient or treatment factors are associated with TTT. Methods and Materials: Included in the study were 237 consecutive patients with Stage III NSCLC treated at University of Michigan Hospital (UM) or the Veterans Affairs Ann Arbor Healthcare System (VA). Patients were treated with either palliative or definitive radiotherapy and radiotherapy alone (n = 106) or either sequential (n = 69) or concurrent chemoradiation (n = 62). The primary endpoint was OS. Results: Median follow-up was 69 months, and median TTT was 57 days. On univariate analysis, the risk of death did not increase significantly with longer TTT (p = 0.093). However, subset analysis showed that there was a higher risk of death with longer TTT in patients who survived ≥ 5 years (p = 0.029). Younger age (p = 0.027), male sex (p = 0.013), lower Karnofsky Performance Score (KPS) (p = 0.002), and treatment at the VA (p = 0.001) were significantly associated with longer TTT. However, on multivariate analysis, only lower KPS remained significantly associated with longer TTT (p = 0.003). Conclusion: Time to treatment is significantly associated with OS in patients with Stage III NSCLC who lived longer than 5 years, although it is not a significant factor in Stage III patients as a whole. Lower KPS is associated with longer TTT.",
keywords = "Non-small cell lung cancer, Stage III, overall survival, time to treatment, treatment delay",
author = "Li Wang and Correa, {Candace R.} and Hayman, {James A.} and Lujun Zhao and Kemp Cease and Dean Brenner and Doug Arenberg and Jeffery Curtis and Kalemkerian, {Gregory P.} and Kong, {Feng Ming}",
year = "2009",
month = "7",
day = "1",
doi = "10.1016/j.ijrobp.2008.08.039",
language = "English (US)",
volume = "74",
pages = "790--795",
journal = "International Journal of Radiation Oncology Biology Physics",
issn = "0360-3016",
publisher = "Elsevier Inc.",
number = "3",

}

TY - JOUR

T1 - Time to Treatment in Patients With Stage III Non-Small Cell Lung Cancer

AU - Wang, Li

AU - Correa, Candace R.

AU - Hayman, James A.

AU - Zhao, Lujun

AU - Cease, Kemp

AU - Brenner, Dean

AU - Arenberg, Doug

AU - Curtis, Jeffery

AU - Kalemkerian, Gregory P.

AU - Kong, Feng Ming

PY - 2009/7/1

Y1 - 2009/7/1

N2 - Purpose: To determine whether time to treatment (TTT) has an effect on overall survival (OS) in patients with unresectable or medically inoperable Stage III non-small cell lung cancer (NSCLC) and whether patient or treatment factors are associated with TTT. Methods and Materials: Included in the study were 237 consecutive patients with Stage III NSCLC treated at University of Michigan Hospital (UM) or the Veterans Affairs Ann Arbor Healthcare System (VA). Patients were treated with either palliative or definitive radiotherapy and radiotherapy alone (n = 106) or either sequential (n = 69) or concurrent chemoradiation (n = 62). The primary endpoint was OS. Results: Median follow-up was 69 months, and median TTT was 57 days. On univariate analysis, the risk of death did not increase significantly with longer TTT (p = 0.093). However, subset analysis showed that there was a higher risk of death with longer TTT in patients who survived ≥ 5 years (p = 0.029). Younger age (p = 0.027), male sex (p = 0.013), lower Karnofsky Performance Score (KPS) (p = 0.002), and treatment at the VA (p = 0.001) were significantly associated with longer TTT. However, on multivariate analysis, only lower KPS remained significantly associated with longer TTT (p = 0.003). Conclusion: Time to treatment is significantly associated with OS in patients with Stage III NSCLC who lived longer than 5 years, although it is not a significant factor in Stage III patients as a whole. Lower KPS is associated with longer TTT.

AB - Purpose: To determine whether time to treatment (TTT) has an effect on overall survival (OS) in patients with unresectable or medically inoperable Stage III non-small cell lung cancer (NSCLC) and whether patient or treatment factors are associated with TTT. Methods and Materials: Included in the study were 237 consecutive patients with Stage III NSCLC treated at University of Michigan Hospital (UM) or the Veterans Affairs Ann Arbor Healthcare System (VA). Patients were treated with either palliative or definitive radiotherapy and radiotherapy alone (n = 106) or either sequential (n = 69) or concurrent chemoradiation (n = 62). The primary endpoint was OS. Results: Median follow-up was 69 months, and median TTT was 57 days. On univariate analysis, the risk of death did not increase significantly with longer TTT (p = 0.093). However, subset analysis showed that there was a higher risk of death with longer TTT in patients who survived ≥ 5 years (p = 0.029). Younger age (p = 0.027), male sex (p = 0.013), lower Karnofsky Performance Score (KPS) (p = 0.002), and treatment at the VA (p = 0.001) were significantly associated with longer TTT. However, on multivariate analysis, only lower KPS remained significantly associated with longer TTT (p = 0.003). Conclusion: Time to treatment is significantly associated with OS in patients with Stage III NSCLC who lived longer than 5 years, although it is not a significant factor in Stage III patients as a whole. Lower KPS is associated with longer TTT.

KW - Non-small cell lung cancer

KW - Stage III

KW - overall survival

KW - time to treatment

KW - treatment delay

UR - http://www.scopus.com/inward/record.url?scp=67049107509&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=67049107509&partnerID=8YFLogxK

U2 - 10.1016/j.ijrobp.2008.08.039

DO - 10.1016/j.ijrobp.2008.08.039

M3 - Article

C2 - 19231108

AN - SCOPUS:67049107509

VL - 74

SP - 790

EP - 795

JO - International Journal of Radiation Oncology Biology Physics

JF - International Journal of Radiation Oncology Biology Physics

SN - 0360-3016

IS - 3

ER -