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Observational Study
. 2020 May 28;54(2):209-220.
doi: 10.2478/raon-2020-0026.

Care of patients with non-small-cell lung cancer stage III - the Central European real-world experience

Milada Zemanova  1 , Robert Pirker  2 , Lubos Petruzelka  1 , Zuzana Zbozínkova  3 , Dragana Jovanovic  4 , Mirjana Rajer  5 , Krisztina Bogos  6 , Gunta Purkalne  7 , Vesna Ceriman  4 , Subhash Chaudhary  8 , Igor Richter  9 , Jirí Kufa  10 , Lenka Jakubikova  11 , Marius Zemaitis  12 , Marketa Cernovska  13 , Leona Koubkova  14 , Zdenka Vilasova  15 , Karin Dieckmann  16 , Attila Farkas  17 , Jelena Spasic  18 , Katerina Fröhlich  3 , Andreas Tiefenbacher  2 , Virag Hollosi  6 , Juraj Kultan  10 , Iveta Kolarová  15 , Jiri Votruba  1
Affiliations
Observational Study

Care of patients with non-small-cell lung cancer stage III - the Central European real-world experience

Milada Zemanova et al. Radiol Oncol. .

Abstract

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.

Keywords: diagnostic procedures; multimodality treatment; non-small-cell lung cancer; stage III.

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Figures

Figure 1
Figure 1
Treatment modalities and combinations.
Figure 2
Figure 2
Overall survival and progression-free survival.
Figure 3
Figure 3
Overall survival and progression-free survival by performance status and weight loss in all patients, stage IIIA and stage IIIB.
Figure 4
Figure 4
Overall survival by variables.
See this image and copyright information in PMC

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