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Sökning: WFRF:(Xanthoulis Panagiotis) > Predictors of long-...

LIBRIS Formathandbok  (Information om MARC21)
FältnamnIndikatorerMetadata
00004623nam a2200457 4500
001oai:DiVA.org:uu-497492
003SwePub
008230228| | |||||||||||000 ||eng|
024a https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-4974922 URI
040 a (SwePub)uu
041 a engb eng
042 9 SwePub
072 7a vet2 swepub-contenttype
072 7a ovr2 swepub-publicationtype
100a Isaksson, Johanu Uppsala universitet,Centrum för klinisk forskning, Gävleborg,Institutionen för immunologi, genetik och patologi,Johan Botling4 aut0 (Swepub:uu)johis237
2451 0a Predictors of long-term survival and recurrence patterns after definitive chemoradiotherapy in stage III NSCLC – a multicenter cohort study from Mid Sweden
338 a print2 rdacarrier
520 a Background: Stage III NSCLC is heterogeneous but often recurs despite intensive treatment with curative intent. Clinical tools to predict the risk and pattern of recurrence and long-term survival in individual patients are largely lacking. Methods: NSCLC stage III patients (N=193) treated 2009-2018 with definitive, curatively intended chemoradiotherapy (CRT, 60Gy+) were retrospectively identified from three healthcare regions in Mid Sweden. Outcome variables included overall survival (OS), progression-free survival (PFS) and recurrence patterns.  Results:  Median follow-up of patients alive was 52 months. 1, 2 and 5-year OS was 80%, 63% and 34% with a mOS of 32 months. Pre-treatment serum inflammatory markers were associated with inferior OS, including leukocyte count > 10 (HR 1.58, 95% CI 1.08-2.31, p=0.018) and CRP > 5 (HR 1.81, 95% CI 1.16-2.83, p=0.009). CRP remained independently associated with OS in multivariable analysis, HR 1.67 (1.05-2.65, p=0.029). No other pre-treatment variable was significantly associated with OS. Progressive disease (PD) was documented in 65% of patients after a median time of 9.5 months, 96% within 3 years from CRT, and was typically either distant or locoregional (12% mixed). Distant PD developed earlier (6.3 months) than locoregional PD (11.5 months; p=0.052).  N3 disease (OR 2.7, 95% CI 1.2-6.3,; p=0.022) and presence of driver mutations (OR 4.6, 95% CI 1.5-14.0; p=0.0076) increased the risk of distant PD, while ≥2 concurrent chemotherapy courses was protective of locoregional PD (OR 0.38, 9% CI 0.1-1.0; p=0.049). Brain metastases were the first indication of PD in 22 patients (12%) and were in all cases isolated without synchronous extracranial PD. A post-CRT 18F-FDG-PET SUVmax of ≥7 was associated with a shorter time to PD (HR 0.41, 95% CI 0.21-0.79, p=0.008).   Conclusions: The study reinforces the prognostic role of systemic inflammation in stage III NSCLC and provides clinically useful indicators of relapse pattern as a basis for rational disease monitoring following CRT. 
650 7a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Cancer och onkologi0 (SwePub)302032 hsv//swe
650 7a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Cancer and Oncology0 (SwePub)302032 hsv//eng
653 a Oncology
653 a Onkologi
700a Xanthoulis, Panagiotis4 aut
700a Broström, Erikau Uppsala universitet,Lung- allergi- och sömnforskning4 aut0 (Swepub:uu)eribr175
700a Börjesson, Rebecka4 aut
700a Olsson, Erik4 aut
700a Willén, Linda,d 1979-u Uppsala universitet,Centrum för klinisk forskning, Gävleborg4 aut0 (Swepub:uu)linwa756
700a Isacsson, Ulf4 aut
700a Sobrino, Pierre4 aut
700a Hansen, Tomasu Uppsala universitet,Radiologi4 aut0 (Swepub:uu)tohan227
700a Mouratidou, Valentina4 aut
700a Holgersson, Georg4 aut
700a Bergqvist, Michael4 aut
700a Tsakonas, Georgios4 aut
700a Ekman, Simon4 aut
700a Micke, Patricku Uppsala universitet,Science for Life Laboratory, SciLifeLab,Institutionen för immunologi, genetik och patologi,Institutionen för medicinsk biokemi och mikrobiologi4 aut0 (Swepub:uu)patmi676
700a Lamberg, Kristinau Uppsala universitet,Lung- allergi- och sömnforskning4 aut0 (Swepub:uu)krila642
700a Botling, Johanu Uppsala universitet,Science for Life Laboratory, SciLifeLab,Institutionen för immunologi, genetik och patologi4 aut0 (Swepub:uu)johanbot
700a Lindskog, Magnusu Uppsala universitet,Institutionen för immunologi, genetik och patologi4 aut0 (Swepub:uu)magli409
710a Uppsala universitetb Centrum för klinisk forskning, Gävleborg4 org
8564 8u https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-497492

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