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K. Neville
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P2.02 - Poster Session with Presenters Present (ID 462)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Locally Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 12/06/2016, 14:30 - 15:45, Hall B (Poster Area)
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P2.02-052 - Does Delay from Diagnosis to Start of Radiotherapy, or Modified Comorbidity Score Impact Survival in Curatively Treated Non Small Cell Lung Cancer (ID 6369)
14:30 - 14:30 | Author(s): K. Neville
- Abstract
Background:
To determine whether the interval from diagnosis to the start of radiotherapy, and modified comorbidity score (Colinet score) are prognostic for survival in non-small cell lung cancer patients treated with curative intent.
Methods:
A prospective database of 471 patients receiving ≥50Gy radiotherapy with or without concurrent chemotherapy for NSCLC between 1993-2013 from two centers in Melbourne and Sydney was analyzed. The date of diagnosis was defined as the date of cytological or histological diagnosis. Weight loss over previous 6 months was characterized as either absent, ≤10% or >10%. Multivariate analysis was performed by Cox regression using SPSS version 23 (Armonk, NY).
Results:
394 patients were eligible for analysis using ECOG performance status (PS), stage, weight loss, modified comorbidity score and delay to start of radiotherapy. Median delay to start of radiotherapy was 47 (range 0-353). Median dose received was 60Gy in 30 fractions (range 50-75Gy, 3-35 fractions). 106 were stage I, 56 were stage II and 232 were stage III. Average age was 68 years. 26 patients received stereotactic body radiotherapy. ECOG, stage and weight loss were all associated with survival (p=0.007, p=0.022, p=0.032 respectively). Modified comorbidity score and interval between diagnosis and start of radiotherapy were not (p=0.101 and p=0.353 respectively). A retrospectively assigned Charlston comorbidity score was available for 271 of the 394 patients who were analysed using the same variables as above but substituting the Charlston score for the modified comorbidity score. ECOG PS and Charlston score were significantly associated with survival (p=0.012 and p=0.046 respectively, but stage, weight loss and interval to radiotherapy were not (p=0.129, p=0.150 and p=0.09 respectively). When Colinet score was introduced to the analysis it did not reach statistical significance (p=0.729) but Charlston score retained it (p=0.042).
Conclusion:
Delay from date of diagnosis to initiation of radiotherapy could not be demonstrated to correlate negatively with survival, at least in the time range encountered in our patients. Although counterintuitive, this is in agreement with the limited published data which are retrospective to our knowledge. The modified comorbidity score was not specifically developed by Colinet et al to prognosticate for lung cancer and indeed appears inadequate for this purpose. The Charlston score however, is confirmed as prognostic in our study and although more complex and time consuming to determine, should be the preferred comorbidity index for prognostication of radically treated non-small cell lung cancer patients.
