TY - JOUR
T1 - Outcomes by tumor histology and kras mutation status after lung stereotactic body radiation therapy for early-stage non-small-cell lung cancer
AU - Mak, Raymond H.
AU - Hermann, Gretchen
AU - Lewis, John H.
AU - Aerts, Hugo J.W.L.
AU - Baldini, Elizabeth H.
AU - Chen, Aileen B.
AU - Colson, Yolonda L.
AU - Hacker, Fred H.
AU - Kozono, David
AU - Wee, Jon O.
AU - Chen, Yu Hui
AU - Catalano, Paul J.
AU - Wong, Kwok Kin
AU - Sher, David J.
N1 - Publisher Copyright:
© 2015 Elsevier Inc. All rights reserved.
PY - 2015/1/1
Y1 - 2015/1/1
N2 - Background We analyzed outcomes after lung stereotactic body radiotherapy (SBRT) for early-stage non-small cell lung-carcinoma (NSCLC) by histology and KRAS genotype. Patients and Methods We included 75 patients with 79 peripheral tumors treated with SBRT (18 Gy × 3 or 10 to 12 Gy × 5) at our institution from 2009 to 2012. Genotyping for KRAS mutations was performed in 10 patients. Outcomes were analyzed by the Kaplan-Meier method/Cox regression, or cumulative incidence method/Fine-Gray analysis. Results The median patient age was 74 (range, 46 to 93) years, and Eastern Cooperative Oncology Group performance status was 0 to 1 in 63%. Tumor histology included adenocarcinoma (44%), squamous cell carcinoma (25%), and NSCLC (18%). Most tumors were T1a (54%). Seven patients had KRAS-mutant tumors (9%). With a median follow-up of 18.8 months among survivors, the 1-year estimate of overall survival was 88%, cancer-specific survival (CSS) 92%, primary tumor control 94%, and freedom from recurrence (FFR) 67%. In patients with KRAS-mutant tumors, there was a significantly lower tumor control (67% vs. 96%; P =.04), FFR (48% vs. 69%; P =.03), and CSS (75% vs. 93%; P =.05). On multivariable analysis, histology was not associated with outcomes, but KRAS mutation (hazard ratio, 10.3; 95% confidence interval, 2.3-45.6; P =.0022) was associated with decreased CSS after adjusting for age. Conclusion In this SBRT series, histology was not associated with outcomes, but KRAS mutation was associated with lower FFR on univariable analysis and decreased CSS on multivariable analysis. Because of the small sample size, these hypothesis-generating results need to be studied in larger data sets.
AB - Background We analyzed outcomes after lung stereotactic body radiotherapy (SBRT) for early-stage non-small cell lung-carcinoma (NSCLC) by histology and KRAS genotype. Patients and Methods We included 75 patients with 79 peripheral tumors treated with SBRT (18 Gy × 3 or 10 to 12 Gy × 5) at our institution from 2009 to 2012. Genotyping for KRAS mutations was performed in 10 patients. Outcomes were analyzed by the Kaplan-Meier method/Cox regression, or cumulative incidence method/Fine-Gray analysis. Results The median patient age was 74 (range, 46 to 93) years, and Eastern Cooperative Oncology Group performance status was 0 to 1 in 63%. Tumor histology included adenocarcinoma (44%), squamous cell carcinoma (25%), and NSCLC (18%). Most tumors were T1a (54%). Seven patients had KRAS-mutant tumors (9%). With a median follow-up of 18.8 months among survivors, the 1-year estimate of overall survival was 88%, cancer-specific survival (CSS) 92%, primary tumor control 94%, and freedom from recurrence (FFR) 67%. In patients with KRAS-mutant tumors, there was a significantly lower tumor control (67% vs. 96%; P =.04), FFR (48% vs. 69%; P =.03), and CSS (75% vs. 93%; P =.05). On multivariable analysis, histology was not associated with outcomes, but KRAS mutation (hazard ratio, 10.3; 95% confidence interval, 2.3-45.6; P =.0022) was associated with decreased CSS after adjusting for age. Conclusion In this SBRT series, histology was not associated with outcomes, but KRAS mutation was associated with lower FFR on univariable analysis and decreased CSS on multivariable analysis. Because of the small sample size, these hypothesis-generating results need to be studied in larger data sets.
KW - Early stage
KW - KRAS
KW - Non-small-cell lung cancer
KW - Stereotactic body radiotherapy
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U2 - 10.1016/j.cllc.2014.09.005
DO - 10.1016/j.cllc.2014.09.005
M3 - Article
C2 - 25450872
AN - SCOPUS:84927554572
SN - 1525-7304
VL - 16
SP - 24
EP - 32
JO - Clinical Lung Cancer
JF - Clinical Lung Cancer
IS - 1
ER -