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pN1 but not pN0/N2 predicts survival benefits of prophylactic cranial irradiation in small-cell lung cancer patients after surgery.

cris.virtual.author-orcid0000-0002-8732-5910
cris.virtualsource.author-orcidf92a6b6d-2f0d-419c-977b-296ec58d16c9
cris.virtualsource.author-orcid4497fd2b-91cc-47e0-b388-c8c3326d5319
cris.virtualsource.author-orcida4a688fa-027d-4b45-9d4a-4a47d8ac0001
datacite.rightsopen.access
dc.contributor.authorYang, Haitang
dc.contributor.authorAl-Hurani, Mohammad
dc.contributor.authorXu, Jianlin
dc.contributor.authorFan, Liwen
dc.contributor.authorSchmid, Ralph
dc.contributor.authorZhao, Heng
dc.contributor.authorYao, Feng
dc.date.accessioned2024-09-21T16:04:15Z
dc.date.available2024-09-21T16:04:15Z
dc.date.issued2021-04
dc.description.abstractBackground Prophylactic cranial irradiation has been shown to reduce brain metastases and provide survival benefits in small-cell lung cancer (SCLC). However, its role in limited-stage SCLC patients after surgery remains unclear. Further, it is unknown whether the effect of prophylactic cranial irradiation is generalizable in these patients with different pathological nodal (N0-N2) stages, a state indicating the presence of tumor metastases. Methods We combined data from a single medical center and Surveillance, Epidemiology, and End Results database. Propensity score matching analyses were performed (1:2) to evaluate the role of prophylactic cranial irradiation in SCLC patients after surgery. Cox proportional hazards regression model was used to identify predictors of survival. Results 124 (18.7%) out of 664 surgically-treated SCLC patients received prophylactic cranial irradiation treatment. Within the entire cohort, multivariate Cox regression analysis identified dataset source, age, pathological T and N stages, adjuvant chemotherapy, resection type, and histology as independent prognostic factors for overall survival. Prophylactic cranial irradiation appeared to be associated with a better overall survival, but the difference is marginally significant (P=0.063). Further, we stratified patients based on the pathological N0-N2 stages using propensity score matching analyses, which showed that prophylactic cranial irradiation treatment was superior to non-prophylactic cranial irradiation treatment for surgically-treated SCLC patients with N1 stage only (univariate analysis: P=0.026; multivariate Cox: P=0.004), but not N0/N2 stage (univariate analysis: P=0.65 and P=0.28, respectively; multivariate Cox: P=0.99 and P=0.35, respectively). Conclusions Prophylactic cranial irradiation provides survival benefits for SCLC patients with pN1 after surgery but not with pathological N0/N2 stage. Our findings may provide helpful stratifications for clinical decision-making of prophylactic cranial irradiation intervention in SCLC patients.
dc.description.sponsorshipDepartment for BioMedical Research (DBMR)
dc.description.sponsorshipUniversitätsklinik für Thoraxchirurgie
dc.description.sponsorshipDepartment for BioMedical Research, Forschungsgruppe Thoraxchirurgie
dc.identifier.doi10.48350/157716
dc.identifier.pmid33987260
dc.identifier.publisherDOI10.21037/atm-20-6984
dc.identifier.urihttps://boris-portal.unibe.ch/handle/20.500.12422/45709
dc.language.isoen
dc.publisherAME Publishing Company
dc.relation.ispartofAnnals of translational medicine
dc.relation.issn2305-5839
dc.relation.organizationDCD5A442BE57E17DE0405C82790C4DE2
dc.relation.organizationDCD5A442BAD7E17DE0405C82790C4DE2
dc.relation.organizationDCD5A442BD18E17DE0405C82790C4DE2
dc.subjectSmall-cell lung cancer (SCLC) nodal metastasis prophylactic cranial irradiation surgery
dc.subject.ddc600 - Technology::610 - Medicine & health
dc.titlepN1 but not pN0/N2 predicts survival benefits of prophylactic cranial irradiation in small-cell lung cancer patients after surgery.
dc.typearticle
dspace.entity.typePublication
oaire.citation.issue7
oaire.citation.startPage562
oaire.citation.volume9
oairecerif.author.affiliationDepartment for BioMedical Research, Forschungsgruppe Thoraxchirurgie
oairecerif.author.affiliationDepartment for BioMedical Research (DBMR)
oairecerif.author.affiliationUniversitätsklinik für Thoraxchirurgie
oairecerif.author.affiliation2Universitätsklinik für Thoraxchirurgie
oairecerif.author.affiliation2Department for BioMedical Research, Forschungsgruppe Thoraxchirurgie
oairecerif.author.affiliation2Department for BioMedical Research, Forschungsgruppe Thoraxchirurgie
unibe.contributor.rolecreator
unibe.contributor.rolecreator
unibe.contributor.rolecreator
unibe.contributor.rolecreator
unibe.contributor.rolecreator
unibe.contributor.rolecreator
unibe.contributor.rolecreator
unibe.date.licenseChanged2021-07-27 19:52:44
unibe.description.ispublishedpub
unibe.eprints.legacyId157716
unibe.refereedtrue
unibe.subtype.articlejournal

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