Lizza E L Hendriks1, -Anita J W M Brouns2, Mohammad Amini3, Wilma Uyterlinde4, Robin Wijsman5, Jan Bussink6, Bonne Biesma7, S Bing Oei8, Jos-A Stigt9, Gerben P Bootsma10, José S A Belderbos11, Dirk K M De Ruysscher12, Michel M Van den Heuvel13, Anne-Marie C Dingemans14. 1. Dept. of Pulmonary Diseases, GROW ⿿ School for Oncology and Developmental Biology, Maastricht University Medical Center+, PO Box 5800, 6202 AZ Maastricht, The Netherlands. Electronic address: lizza.hendriks@mumc.nl. 2. Dept. of Pulmonary Diseases, Zuyderland Medical Center location Heerlen, PO Box 5500, 6130 MB Sittard-Geleen, The Netherlands. Electronic address: a.brouns@zuyderland.nl. 3. Dept. of Pulmonary Diseases, Jeroen Bosch Hospital, PO Box 90153, 5200 ME ⿿s Hertogenbosch, The Netherlands. Electronic address: M.Amini@jbz.nl. 4. Dept. of Thoracic Oncology, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, PO Box 90203, 1006 BE Amsterdam, The Netherlands. Electronic address: W.uyterlinde@nki.nl. 5. Dept. of Radiation Oncology, Radboud University Hospital, PO Box 9100, 6500 HA Nijmegen, The Netherlands. Electronic address: Robin.Wijsman@radboudumc.nl. 6. Dept. of Radiation Oncology, Radboud University Hospital, PO Box 9100, 6500 HA Nijmegen, The Netherlands. Electronic address: Jan.Bussink@radboudumc.nl. 7. Dept. of Pulmonary Diseases, Jeroen Bosch Hospital, PO Box 90153, 5200 ME ⿿s Hertogenbosch, The Netherlands. Electronic address: b.biesma@jbz.nl. 8. Dept. of Radiation Oncology, Institute Verbeeten, PO Box 90120, 5000 LA Tilburg, The Netherlands. Electronic address: oei@bvi.nl. 9. Dept. of Pulmonary Diseases, Isala Clinics, PO Box 10400, 8000 GK Zwolle, The Netherlands. Electronic address: j.a.stigt@isala.nl. 10. Dept. of Pulmonary Diseases, Zuyderland Medical Center location Heerlen, PO Box 5500, 6130 MB Sittard-Geleen, The Netherlands. Electronic address: g.bootsma@zuyderland.nl. 11. Dept. of Radiation Oncology, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, PO Box 90203, 1006 BE Amsterdam, The Netherlands. Electronic address: j.belderbos@nki.nl. 12. Dept. of Radiation Oncology (MAASTRO Clinic), GROW ⿿ School for Oncology and Developmental Biology, Maastricht University Medical Center+, PO Box 3035, 6202 NA Maastricht, The Netherlands. Electronic address: dirk.deruysscher@maastro.nl. 13. Dept. of Thoracic Oncology, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, PO Box 90203, 1006 BE Amsterdam, The Netherlands. Electronic address: m.vd.heuvel@nki.nl. 14. Dept. of Pulmonary Diseases, GROW ⿿ School for Oncology and Developmental Biology, Maastricht University Medical Center+, PO Box 5800, 6202 AZ Maastricht, The Netherlands. Electronic address: a.dingemans@mumc.nl.
Abstract
OBJECTIVES: Symptomatic brain metastases (BM) occur frequently after chemoradiotherapy (CRT) for stage III NSCLC. Aim of the current study was to determine whether the specific chemotherapy used in a CRT regimen influences BM development. MATERIALS AND METHODS: Retrospective multicenter study including all consecutive stage III NSCLC who completed CRT. Primary endpoints: symptomatic BM development, whether this was the only site of first relapse. Differences between regimens were assessed with a logistic regression model including known BM risk factors and the specific chemotherapy: concurrent versus sequential (cCRT/sCRT), within cCRT: daily low dose cisplatin (LDC)-cyclic dose polychemotherapy; LDC-(non-)taxane cyclic dose; LDC-polychemotherapy subgroups of ≥50 patients. RESULTS: Between January 2006 and June 2014, 838 patients were eligible (737 cCRT, 101 sCRT). 18.2% developed symptomatic BM, 8.0% had BM as only site of first relapse. BM patients were significantly younger, female, had more advanced N-stage and had adenocarcinoma histology. In both cCRT and sCRT BM were found in 18% (p=0.904). In cyclic dose cCRT (N=346) and LDC (N=391) BM were found in 18.8% and 17.9%, respectively (p=0.757). In 7.2% and 8.7%, respectively, BM were the only site of first relapse (p=0.463). The chemotherapy used (cCRT versus sCRT) had no influence on BM development, not for all brain relapses nor as only site of first relapse (OR 0.88 (p=0.669), OR 0.93 (p=0.855), respectively). LDC versus cyclic dose cCRT was not significantly different: neither for all brain relapses nor as only site of first relapse (OR 0.96 (p=0.819), OR 1.21 (p=0.498), respectively). Comparable results were found for LDC versus cyclic dose non-taxane (N=277) and cyclic dose taxane regimens (N=69) and for cCRT regimens with ≥50 patients (LDC versus cisplatin/etoposide (N=188), cisplatin/vinorelbin (N=65), weekly cisplatin/docetaxel (N=60)). CONCLUSION: approximately 18% developed symptomatic BM after stage III diagnosis, not dependent on type of chemotherapy regimen used within a CRT treatment.
OBJECTIVES: Symptomatic brain metastases (BM) occur frequently after chemoradiotherapy (CRT) for stage III NSCLC. Aim of the current study was to determine whether the specific chemotherapy used in a CRT regimen influences BM development. MATERIALS AND METHODS: Retrospective multicenter study including all consecutive stage III NSCLC who completed CRT. Primary endpoints: symptomatic BM development, whether this was the only site of first relapse. Differences between regimens were assessed with a logistic regression model including known BM risk factors and the specific chemotherapy: concurrent versus sequential (cCRT/sCRT), within cCRT: daily low dose cisplatin (LDC)-cyclic dose polychemotherapy; LDC-(non-)taxane cyclic dose; LDC-polychemotherapy subgroups of ≥50 patients. RESULTS: Between January 2006 and June 2014, 838 patients were eligible (737 cCRT, 101 sCRT). 18.2% developed symptomatic BM, 8.0% had BM as only site of first relapse. BM patients were significantly younger, female, had more advanced N-stage and had adenocarcinoma histology. In both cCRT and sCRT BM were found in 18% (p=0.904). In cyclic dose cCRT (N=346) and LDC (N=391) BM were found in 18.8% and 17.9%, respectively (p=0.757). In 7.2% and 8.7%, respectively, BM were the only site of first relapse (p=0.463). The chemotherapy used (cCRT versus sCRT) had no influence on BM development, not for all brain relapses nor as only site of first relapse (OR 0.88 (p=0.669), OR 0.93 (p=0.855), respectively). LDC versus cyclic dose cCRT was not significantly different: neither for all brain relapses nor as only site of first relapse (OR 0.96 (p=0.819), OR 1.21 (p=0.498), respectively). Comparable results were found for LDC versus cyclic dose non-taxane (N=277) and cyclic dose taxane regimens (N=69) and for cCRT regimens with ≥50 patients (LDC versus cisplatin/etoposide (N=188), cisplatin/vinorelbin (N=65), weekly cisplatin/docetaxel (N=60)). CONCLUSION: approximately 18% developed symptomatic BM after stage III diagnosis, not dependent on type of chemotherapy regimen used within a CRT treatment.
Authors: Noëlle van der Voort van Zyp; Masoma Hashimzadah; Erik Kouwenhoven; Carmen Liskamp; Christa Gadellaa-van Hooijdonk; Ellen Pouw; Jose Belderbos; Klaartje Maas; Paul van de Vaart; Mirjam Mast Journal: Clin Transl Radiat Oncol Date: 2022-07-07
Authors: Simon A Keek; Esma Kayan; Avishek Chatterjee; José S A Belderbos; Gerben Bootsma; Ben van den Borne; Anne-Marie C Dingemans; Hester A Gietema; Harry J M Groen; Judith Herder; Cordula Pitz; John Praag; Dirk De Ruysscher; Janna Schoenmaekers; Hans J M Smit; Jos Stigt; Marcel Westenend; Haiyan Zeng; Henry C Woodruff; Philippe Lambin; Lizza Hendriks Journal: Ther Adv Med Oncol Date: 2022-08-22 Impact factor: 5.485