Predictors of Long-Term Survival in Patients with Lung Cancer Included in the Randomized Spanish Lung Cancer Group 0008 Phase II Trial Using Concomitant Chemoradiation with Docetaxel and Carboplatin plus Induction or Consolidation Chemotherapy

Docetaxel and Carboplatin Plus Induction or Consolidation Chemotherapy

Pilar Garrido; Rafael Rosell; Bartomeu Massutí; Felipe Cardenal; Vicente Alberola; Manuel Dómine; Inmaculada Maeztu; Alfredo Ramos; Antonio Arellano

Disclosures

Clin Lung Cancer. 2009;10(3):180-186. 

In This Article

Results

A total of 139 patients were included in this retrospective analysis of prognostic variables. The median follow-up was 23 months for living patients and 12 months for the entire group. Table 1 shows the baseline characteristics of the patients. Median age was 61.37 years (range, 41-78 years) in the consolidation arm and 61.30 years (range, 37-78 years) in the induction arm. Ninety-one percent of the patients were men, evenly distributed between the 2 arms. There were no differences between the arms in the proportion of patients with PS 0 or PS 1. Approximately half the patients had squamous cell carcinoma ( Table 1 ).

Grade 3/4 toxicities are shown in Table 2 . As expected, the treatment was well tolerated in terms of hematologic toxicities. Sixteen percent of the patients in the consolidation arm and 15% in the induction arm had grade 3/4 esophagitis. The acute pneumonitis rates were 2.9% and 1.4%, respectively. Four patients died in the consolidation arm, 3 as a result of febrile neutropenia and 1 as a result of bilateral pneumonia. Only 38 patients (54%) completed the treatment according to protocol in the consolidation arm, whereas 45 patients (65%) completed treatment in the induction arm. Reasons for treatment discontinuation are listed in Table 3 .

Median survival from time of registration was 13.07 months (95% CI, 8.77-16.20) for the consolidation arm and 14.65 months (95% CI, 11.60-24.01) for the induction arm (P = .12). The 2-year survival rates were 31.34% and 42.65%, respectively (P = .17), and the 4-year survival rates were 25.37% and 32.35%, respectively (P = .37). Table 4 shows the median, 2-year, and 4-year survival for each arm according to each variable.

A univariate regression analysis ( Table 5 ) and a Cox multivariate regression analysis ( Table 6 ) of prognostic factors were performed on all patients. Survival was not influenced by age, disease stage, histology, PS, sequence of treatment (consolidation vs. induction), FEV1, Hb level, nodal status, or prolonged interruption of TRT. The only independent prognostic factors were completion of TRT (hazard ratio [HR], 0.33; 95% CI, 0.20-0.56; P < .0001) and completion of induction or consolidation plus concomitant treatment (HR, 0.22; 95% CI, 0.13-0.37; P < .0001).

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