INFORMAZIONI SU QUESTO ARTICOLO

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Figure 1

Flow chart showing patient selection. The patients were treated with concurrent chemoradiotherapy between January 2011 and December 2018.PFS = progression-free survival
Flow chart showing patient selection. The patients were treated with concurrent chemoradiotherapy between January 2011 and December 2018.PFS = progression-free survival

Figure 2

PROGRESSION-FREE survival (PFS) and post-progression survival (PPS) in the overall population.
PROGRESSION-FREE survival (PFS) and post-progression survival (PPS) in the overall population.

Figure 3

Kaplan-Meier survival plots showing the (A) progression-free survival (PFS) and (B) overall survival (OS) of all patients.Median progression-free survival: 10.8 months; median overall survival: 31.6 months; median follow-up: 31.5 months.
Kaplan-Meier survival plots showing the (A) progression-free survival (PFS) and (B) overall survival (OS) of all patients.Median progression-free survival: 10.8 months; median overall survival: 31.6 months; median follow-up: 31.5 months.

Figure 4

Correlations between (A) overall survival (OS) and progression-free survival (PFS) and (B) between overall survival and post-progression survival (PPS).*The r values represent Spearman’s rank correlation coefficient. **The R2 values represent the linear regression.
Correlations between (A) overall survival (OS) and progression-free survival (PFS) and (B) between overall survival and post-progression survival (PPS).*The r values represent Spearman’s rank correlation coefficient. **The R2 values represent the linear regression.

Figure 5

(A) Kaplan-Meier plots showing post-progression survival (PPS) according to Glasgow prognostic score (GPS) at relapse, GPS 0–1, median = 25.7 months; GPS 2, median = 6.7 months. (B) Kaplan-Meier plots showing PPS according to liver metastases at recurrence, Without liver metastases, median = 21.3 months; With liver metastases, median = 4.2 months
(A) Kaplan-Meier plots showing post-progression survival (PPS) according to Glasgow prognostic score (GPS) at relapse, GPS 0–1, median = 25.7 months; GPS 2, median = 6.7 months. (B) Kaplan-Meier plots showing PPS according to liver metastases at recurrence, Without liver metastases, median = 21.3 months; With liver metastases, median = 4.2 months

Baseline patient characteristics

Characteristic N = 45
Gender
        Male/female 33/12
Median age at chemoradiotherapy (years) 71 (41–80)
Median age at progressive disease (years) 71 (42–82)
Performance Status at progressive disease
        0/1/2/3/4 15/22/4/4/0
Smoking history
        Yes/No 36/9
Histology
        Adenocarcinoma/squamous cell carcinoma/others 23/16/6
Clinical stage at diagnosis
        IIIA/IIIB/IIIC 28/14/3
Driver mutation/translocation
        EGFR/ALK/ROS-1/BRAF/others/negative or unknown 6/2/1/0/0/36
PD-L1 TPS
        < 1% / 1–49% / 50%/unknown 6/5/8/26
Progression-free survival (months) .
        < 6 / 6 13/32
Overall response to chemoradiotherapy
        CR/PR/SD/PD/NE 0/26/15/4/0
Glasgow prognostic score (GPS)
        0–1/2 32/13
Administration of tyrosine kinase inhibitors
        Yes/No 11/34
Administration of immune checkpoint inhibitors
        Yes/No 12/33
Administration of durvalmab
        Yes/No 2/43
Recurrent pattern
        Local recurrence/distant metastasis 17/28
Intracranial metastases at recurrence
        Yes/No 7/38
Liver metastases at recurrence
        Yes/No 3/42
Bone metastases at recurrence
        Yes/No 15/30
Oligorecurrrence
        Yes/No 11/34
Radiotherapy after recurrence (any site)
        Yes/No 19/26
Number of drug therapies after chemoradiotherapy
        0/1/2/3/4 14/18/9/2/2
        Median (range) 1
Median (range) radiation dosage (Gy) 60 (58–70)
Chemotherapy regimen
        CDDP + VNR 1
        CDDP + S-1 0
        CBDCA + PTX 30
        Low dose CBDCA 14

Univariate Cox regression analysis of patient characteristics for post-progression survival

Median Post-progression survival
PPS Univariate analysis Multivariate analysis
Factors (months) HR 95% CI p value HR 95% CI p value
Gender
        Male/female 18.1/25.7 1.49 0.63–4.07 0.37
Age at recurrence (years)
        < 75 / 75 20.0/19.5 0.78 0.36–1.77 0.54
PS at recurrence
        0–1 / 2 21.3/2.8 0.42 0.18–1.09 0.07
Smoking history
        Yes/No 16.7/25.7 1.87 0.71–6.39 0.21
Histology
        Adenocarcinoma/non-adenocarcinoma 25.7/10.5 0.37 0.17–0.79 0.0099 1.06 0.36–3.04 0.90
Driver mutation/translocation
        Yes/No 27.3/15.1 0.32 0.07–0.95 0.038 0.61 0.13–2.23 0.47
Best overall response of chemoradiotherapy
        PR/non-PR 15.1/22.1 1.82 0.86–4.11 0.11
Progression-free survival
        < 6 months / 6 months 6.4 / 24.4 1.97 0.89–4.19 0.09
Glasgow prognostic score (GPS) at recurrence
        0–1/2 25.7/6.7 0.23 0.11–0.52 0.0006 0.2 0.06–0.55 0.0019
Recurrence pattern
        Local recurrence/distant metastasis 40.7/16.7 0.45 0.18–1.03 0.05
Intracranial metastases at recurrence
        Yes/No 6.7/21.3 1.75 0.64–4.09 0.25
Liver metastases at recurrence
        Yes/No 4.2/21.3 6.82 1.50–22.8 0.016 12.7 2.40–56.8 0.0048
Bone metastases at recurrence
        Yes/No 18.1/20.0 1.40 0.60–3.06 0.41
Oligorecurrence at recurrence
        Yes/No 22.1/19.2 0.77 0.30–1.75 0.55

The treatments after post-chemoradiotherapy recurrence

first-line second-line third-line ≧fourth-line Total
Platinum combination 11 3 2 0 16
Platinum combination + ICIs 0 0 0 0 0
Docetaxel 0 4 2 0 6
Docetaxel+ ramcirumab 0 0 0 0 0
Pemetrexed 0 0 2 0 2
S1 1 0 0 3 4
Others (single agents) 0 1 0 0 1
EGFR-TKIs 6 1 0 0 7
ALK-TKIs 3 1 0 0 4
ICI monotherapy 1 5 2 1 9
Ipilimumab+nivolumab 1 0 0 0 1
Investigational agents 0 0 0 0 0
Radiotherapy alone 12 1 0 0 13
Best supportive care 10 - - - 10
eISSN:
1581-3207
Lingua:
Inglese
Frequenza di pubblicazione:
4 volte all'anno
Argomenti della rivista:
Medicine, Clinical Medicine, Internal Medicine, Haematology, Oncology, Radiology