Prognostic factors for survival in unresectable stage III EGFR mutation-positive lung adenocarcinoma: impact of pre-CCRT PET-CT

Wei-Chun Lin; Wan-Ming Chen; Ben-Chang Shia; Szu-Yuan Wu

doi:10.1136/thorax-2023-220702

Prognostic factors for survival in unresectable stage III EGFR mutation-positive lung adenocarcinoma: impact of pre-CCRT PET-CT

Thorax. 2024 Feb 8:thorax-2023-220702. doi: 10.1136/thorax-2023-220702. Online ahead of print.

Authors

Wei-Chun Lin^#¹, Wan-Ming Chen^#^{2

3}, Ben-Chang Shia^{2

4}, Szu-Yuan Wu^{5

3

4

6

7

8

9

10

11}

Affiliations

¹ Division of Chest Medicine, Department of Internal Medicine, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan, Taiwan.
² Graduate Institute of Business Administration, College of Management, Fu Jen Catholic University, Taipei, Taiwan.
³ Big Data Center, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan, Taiwan.
⁴ Artificial Intelligence Development Center, Fu Jen Catholic University, Taipei, Taiwan.
⁵ Graduate Institute of Business Administration, College of Management, Fu Jen Catholic University, Taipei, Taiwan szuyuanwu5399@gmail.com.
⁶ Department of Food Nutrition and Health Biotechnology, College of Medical and Health Science, Asia University, Taichung, Taiwan.
⁷ Division of Radiation Oncology, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan, Taiwan.
⁸ Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan.
⁹ Cancer Center, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan, Taiwan.
¹⁰ Centers for Regional Anesthesia and Pain Medicine, Taipei Municipal Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
¹¹ Department of Management, College of Management, Fo Guang University, Yilan, Taiwan.

^# Contributed equally.

PMID: 38331580
DOI: 10.1136/thorax-2023-220702

Abstract

Purpose: To assess the survival impact of pre-concurrent chemoradiotherapy (CCRT) staging with positron emission tomography-CT (PET-CT) in patients with unresectable epidermal growth factor receptor (EGFR) mutation-positive adenocarcinoma.

Methods: Patients with unresectable stage IIIA-IIIC EGFR mutation-positive adenocarcinoma undergoing definitive CCRT were divided into two groups: those who received PET-CT staging prior to CCRT and those with other staging methods. Survival outcomes were compared after propensity score matching.

Results: Analysis of 11 856 patients (5928 in each group) showed that PET-CT staging was associated with improved survival (adjusted HR of all-cause mortality: 0.74, 95% CI 0.71 to 0.79). Other prognostic factors included male sex, age group, clinical stage, adjuvant treatment, smoking status, Charlson Comorbidity Index score and treatment setting.

Conclusion: Pre-CCRT staging with PET-CT in patients with unresectable EGFR mutation-positive adenocarcinoma of clinical stage IIIA-IIIC was associated with enhanced survival. Independent prognostic factors were also identified.

Keywords: Lung Cancer.