Development of symptomatic brain metastases after chemoradiotherapy for stage III non-small cell lung cancer: Does the type of chemotherapy regimen matter?

Lizza E L Hendriks; -Anita J W M Brouns; Mohammad Amini; Wilma Uyterlinde; Robin Wijsman; Jan Bussink; Bonne Biesma; S Bing Oei; Jos-A Stigt; Gerben P Bootsma; José S A Belderbos; Dirk K M De Ruysscher; Michel M Van den Heuvel; Anne-Marie C Dingemans

doi:10.1016/j.lungcan.2016.09.008

Development of symptomatic brain metastases after chemoradiotherapy for stage III non-small cell lung cancer: Does the type of chemotherapy regimen matter?

Lizza E L Hendriks
, -Anita J W M Brouns
, Mohammad Amini
, Wilma Uyterlinde
, Robin Wijsman
, Jan Bussink
, Bonne Biesma
, S Bing Oei
, Jos-A Stigt
, Gerben P Bootsma
, José S A Belderbos
, Dirk K M De Ruysscher
, Michel M Van den Heuvel
, Anne-Marie C Dingemans

Research output: Contribution to journal › Article › Academic › peer-review

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.

Original language	English
Pages (from-to)	68-75
Number of pages	8
Journal	Lung Cancer
Volume	101
DOIs	https://doi.org/10.1016/j.lungcan.2016.09.008
Publication status	Published - Nov 2016
Externally published	Yes

Keywords

Adult
Aged
Aged, 80 and over
Antineoplastic Agents/pharmacology
Antineoplastic Combined Chemotherapy Protocols/pharmacology
Brain/pathology
Brain Neoplasms/drug therapy
Bridged-Ring Compounds/therapeutic use
Carcinoma, Non-Small-Cell Lung/complications
Chemoradiotherapy/methods
Cisplatin
Combined Modality Therapy
Docetaxel
Etoposide
Female
Humans
Lung Neoplasms/complications
Male
Middle Aged
Neoplasm Staging
Retrospective Studies
Risk Factors
Survival Analysis
Taxoids/therapeutic use
Treatment Outcome
Vinblastine/analogs & derivatives
Vinorelbine

Access to Document

10.1016/j.lungcan.2016.09.008Licence: CC BY

Cite this

Hendriks, L. E. L., Brouns, .-A. J. W. M., Amini, M., Uyterlinde, W., Wijsman, R., Bussink, J., Biesma, B., Oei, S. B., Stigt, J.-A., Bootsma, G. P., Belderbos, J. S. A., De Ruysscher, D. K. M., Van den Heuvel, M. M., & Dingemans, A.-M. C. (2016). Development of symptomatic brain metastases after chemoradiotherapy for stage III non-small cell lung cancer: Does the type of chemotherapy regimen matter? Lung Cancer, 101, 68-75. https://doi.org/10.1016/j.lungcan.2016.09.008

@article{16491d5b40c644f083d5d0b686e24317,

title = "Development of symptomatic brain metastases after chemoradiotherapy for stage III non-small cell lung cancer: Does the type of chemotherapy regimen matter?",

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.",

keywords = "Adult, Aged, Aged, 80 and over, Antineoplastic Agents/pharmacology, Antineoplastic Combined Chemotherapy Protocols/pharmacology, Brain/pathology, Brain Neoplasms/drug therapy, Bridged-Ring Compounds/therapeutic use, Carcinoma, Non-Small-Cell Lung/complications, Chemoradiotherapy/methods, Cisplatin, Combined Modality Therapy, Docetaxel, Etoposide, Female, Humans, Lung Neoplasms/complications, Male, Middle Aged, Neoplasm Staging, Retrospective Studies, Risk Factors, Survival Analysis, Taxoids/therapeutic use, Treatment Outcome, Vinblastine/analogs \& derivatives, Vinorelbine",

author = "Hendriks, \{Lizza E L\} and Brouns, \{-Anita J W M\} and Mohammad Amini and Wilma Uyterlinde and Robin Wijsman and Jan Bussink and Bonne Biesma and Oei, \{S Bing\} and Jos-A Stigt and Bootsma, \{Gerben P\} and Belderbos, \{Jos{\'e} S A\} and \{De Ruysscher\}, \{Dirk K M\} and \{Van den Heuvel\}, \{Michel M\} and Dingemans, \{Anne-Marie C\}",

year = "2016",

month = nov,

doi = "10.1016/j.lungcan.2016.09.008",

language = "English",

volume = "101",

pages = "68--75",

journal = "Lung Cancer",

issn = "0169-5002",

publisher = "Elsevier Ireland Ltd",

}

Hendriks, LEL, Brouns, -AJWM, Amini, M, Uyterlinde, W, Wijsman, R, Bussink, J, Biesma, B, Oei, SB, Stigt, J-A, Bootsma, GP, Belderbos, JSA, De Ruysscher, DKM, Van den Heuvel, MM & Dingemans, A-MC 2016, 'Development of symptomatic brain metastases after chemoradiotherapy for stage III non-small cell lung cancer: Does the type of chemotherapy regimen matter?', Lung Cancer, vol. 101, pp. 68-75. https://doi.org/10.1016/j.lungcan.2016.09.008

TY - JOUR

T1 - Development of symptomatic brain metastases after chemoradiotherapy for stage III non-small cell lung cancer

T2 - Does the type of chemotherapy regimen matter?

AU - Hendriks, Lizza E L

AU - Brouns, -Anita J W M

AU - Amini, Mohammad

AU - Uyterlinde, Wilma

AU - Wijsman, Robin

AU - Bussink, Jan

AU - Biesma, Bonne

AU - Oei, S Bing

AU - Stigt, Jos-A

AU - Bootsma, Gerben P

AU - Belderbos, José S A

AU - De Ruysscher, Dirk K M

AU - Van den Heuvel, Michel M

AU - Dingemans, Anne-Marie C

PY - 2016/11

Y1 - 2016/11

N2 - 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.

AB - 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.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Antineoplastic Agents/pharmacology

KW - Antineoplastic Combined Chemotherapy Protocols/pharmacology

KW - Brain/pathology

KW - Brain Neoplasms/drug therapy

KW - Bridged-Ring Compounds/therapeutic use

KW - Carcinoma, Non-Small-Cell Lung/complications

KW - Chemoradiotherapy/methods

KW - Cisplatin

KW - Combined Modality Therapy

KW - Docetaxel

KW - Etoposide

KW - Female

KW - Humans

KW - Lung Neoplasms/complications

KW - Male

KW - Middle Aged

KW - Neoplasm Staging

KW - Retrospective Studies

KW - Risk Factors

KW - Survival Analysis

KW - Taxoids/therapeutic use

KW - Treatment Outcome

KW - Vinblastine/analogs & derivatives

KW - Vinorelbine

U2 - 10.1016/j.lungcan.2016.09.008

DO - 10.1016/j.lungcan.2016.09.008

M3 - Article

C2 - 27794410

SN - 0169-5002

VL - 101

SP - 68

EP - 75

JO - Lung Cancer

JF - Lung Cancer

ER -

Development of symptomatic brain metastases after chemoradiotherapy for stage III non-small cell lung cancer: Does the type of chemotherapy regimen matter?

Abstract

Keywords

Access to Document

Fingerprint

Cite this