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Locoregional Recurrent Versus de Novo Locally Advanced NSCLC: Patient Outcomes

By: Cordi Craig
Posted: Tuesday, May 26, 2020

It is unknown how patient outcomes compare between those with isolated locoregional recurrent non–small cell lung cancer (NSCLC) and those with de novo locally advanced NSCLC. Results from a recent study indicated that, among those treated with definitive intent, outcomes were similar between both patient groups. The findings were originally slated for presentation at the 2020 NCCN Annual Conference (Abstract CLO20-036) and published in the JNCCN–Journal of the National Comprehensive Cancer Network.

“These data support the use of aggressive combined-modality treatment in lieu of systemic therapy alone for patients with locally recurrent disease,” concluded Russell Hales, MD, and colleagues at Johns Hopkins School of Medicine, Baltimore.

Using accessed records, the research team identified more than 2,000 patients with NSCLC treated with definitive radiotherapy between 2008 and 2018. Of the 94 patients who had isolated locoregional recurrent disease, 59 met inclusion criteria. The investigators compared this subgroup with 303 patients with de novo locally advanced NSCLC. Isolated locoregional recurrence was defined as any recurrence within the ipsilateral lung and the N1 to N3 nodal groups.

Most of the patients (n= 34) with locoregional recurrent NSCLC had stage I disease and were treated with surgery (n = 31) or stereotactic body radiation therapy (n = 13), alone. At recurrence, 41 patients had stage IIIA disease. Definitive salvage chemoradiotherapy or trimodal therapy were offered to most patients.

No significant differences were reported in progression-free survival between those with recurrent (17.0 months) and those with locally advanced (11.6 months) disease. Similarly, the time to distant metastasis did not differ between the two groups (35.7 vs. 25.9 months, respectively). However, patients with recurrent disease achieved significantly longer overall survival outcomes (49.9 months) than those with locally advanced NSCLC (29.8 months; P = .02).

Disclosure: Ranh Voong, MD, MPH, received grants from the Lung Cancer Research Foundation and Radiology Oncology Institute as well as honoraria from ASCO Advantage. All other study authors reported no conflicts of interest.



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