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  • Title: Swedish lung cancer radiation study group: predictive value of histology for radiotherapy response in patients with non-small cell lung cancer.
    Author: Holgersson G, Bergström S, Bergqvist M, Nyman J, Hoye E, Helsing M, Friesland S, Holgersson M, Birath E, Ekman S, Blystad T, Ewers SB, Mörth C, Löden B, Henriksson R.
    Journal: Eur J Cancer; 2011 Nov; 47(16):2415-21. PubMed ID: 21726999.
    Abstract:
    The aim of the present study was to evaluate the potential predictive value of histology in non-small cell lung cancer (NSCLC) treated with curatively intended radiotherapy. In a collaborative effort among all the Swedish Oncology Departments, clinical data were collected for 1146 patients with a diagnosed non-small cell lung cancer subjected to curatively intended irradiation (⩾50 Gy) during the years 1990 to 2000. The included patients were identified based on a manual search of all medical and radiation charts at the oncology departments from which the individual patient data were collected. Only patients who did not have a histological diagnosis date and death date/last follow-up date were excluded (n=141). Among the 1146 patients with non-small cell carcinoma eligible for analysis, 919 were diagnosed with either adenocarcinoma (n=323) or squamous cell carcinoma (n=596) and included in this study. The median survival for the 919 patients was 14.8 months, while the 5-year survival rate was 9.5%. Patients with adenocarcinoma had a significantly better overall survival compared with patients with squamous cell carcinoma (p=0.0062, log-rank test). When comparing different stages, this survival benefit was most pronounced for stages IIA-IIB (p<0.0001, log-rank test). The difference in survival between the two histological groups was statistically significant in a univariate Cox analysis (p=0.0063) as well as in two multivariate Cox analyses including demographic and treatment variables (p=0.037 and p=0.048, respectively). In this large population based retrospective study we describe for the first time that patients with adenocarcinoma have a better survival after curatively intended radiation therapy in comparison with squamous cell carcinoma patients, particularly those with clinical stages IIA-IIB.
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