Care of patients with non-small-cell lung cancer stage III – the Central European real-world experience
Article Category: Research Article
Published Online: May 28, 2020
Page range: 209 - 220
Received: Jan 09, 2020
Accepted: Apr 14, 2020
DOI: https://doi.org/10.2478/raon-2020-0026
© 2020 Milada Zemanova, Robert Pirker, Lubos Petruzelka, Zuzana Zbozínkova, Dragana Jovanovic, Mirjana Rajer, Krisztina Bogos, Gunta Purkalne, Vesna Ceriman, Subhash Chaudhary, Igor Richter, Jirí Kufa, Lenka Jakubikova, Marius Zemaitis, Marketa Cernovska, Leona Koubkova, Zdenka Vilasova, Karin Dieckmann, Attila Farkas, Jelena Spasic, Katerina Fröhlich, Andreas Tiefenbacher, Virag Hollosi, Juraj Kultan, Iveta Kolarová, Jiri Votruba, published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.
Background
Management of non-small-cell lung cancer (NSCLC) is affected by regional specificities. The present study aimed at determining diagnostic and therapeutic procedures including outcome of patients with NSCLC stage III in the real-world setting in Central European countries to define areas for improvements
Patients and methods
This multicentre, prospective and non-interventional study collected data of patients with NSCLC stage III in a web-based registry and analysed them centrally.
Results
Between March 2014 and March 2017, patients (n=583) with the following characteristics were entered: 32% females, 7% never-smokers; ECOG performance status (PS) 0, 1, 2 and 3 in 25%, 58%, 12% and 5%, respectively; 21% prior weight loss; 53% squamous carcinoma, 38% adenocarcinoma; 10% EGFR mutations. Staging procedures included chest X-ray (97% of patients), chest CT (96%), PET-CT (27%), brain imaging (20%), bronchoscopy (89%), endobronchial ultrasound (EBUS) (13%) and CT-guided biopsy (9%). Stages IIIA/IIIB were diagnosed in 55%/45% of patients, respectively. N2/N3 nodes were diagnosed in 60%/23% and pathologically confirmed in 29% of patients. Most patients (56%) were treated by combined modalities. Surgery plus chemotherapy was administered to 20%, definitive chemoradiotherapy to 34%, chemotherapy only to 26%, radiotherapy only to 12% and best supportive care (BSC) to 5% of patients. Median survival and progression-free survival times were 16.8 (15.3;18.5) and 11.2 (10.2;12.2) months, respectively. Stage IIIA, female gender, no weight loss, pathological mediastinal lymph node verification, surgery and combined modality therapy were associated with longer survival.
Conclusions
The real-world study demonstrated a broad heterogeneity in the management o f stage III NSCLC in Central European countries and suggested to increase the rates of PET-CT imaging, brain imaging and invasive mediastinal staging.