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000306357 1001_ $$0P:(DE-HGF)0$$aGuberina, Maja$$b0
000306357 245__ $$aPathologic Complete Response Predicts Long-Term Survival Following Neoadjuvant Induction Chemotherapy and Chemo-Radiotherapy in Stage-III Non-Small Cell Lung Cancer.
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000306357 520__ $$aTo analyze the association of pathologic-complete-response (PCR) and survival after neoadjuvant concurrent chemo-radiotherapy, we evaluated a large cohort of patients with potentially resectable stage IIIA-IIIC non-small cell lung cancer (NSCLC) treated with a trimodality approach.Consecutive patients underwent neoadjuvant induction chemotherapy, followed by concurrent chemo-radiotherapy and surgery. Patients received established imaging, and diagnostics. Leave-one-out cross-validation was employed to identify the most effective prognostic classifier.Altogether, 403 patients treated between 06/2000 and 01/2020 were included. Median follow-up was 111 months (IQR: 71-127 months). PCR was achieved in 34% (137 patients) after neoadjuvant therapy and major-pathologic response without PCR in 30% (MPR> 0%-≤ 10% defined as viable cells in > 0% and ≤ 10% of the sample). PCR was significantly dependent on histology (p = 0.0005) and radiotherapy fractionation schedule (p = 0.027). PCR rates were higher for squamous than for non-squamous carcinoma with 46.2% (95% CI: 37.8%-54.7%) versus 27.3% (95% CI: 22.0%-33.2%). PCR was the most significant prognostic factor for long-term survival with an associated hazard ratio of 0.272 (0.192-0.386), while MPR was associated with a hazard ratio of 0.671 (0.498-0.905) in comparison to lesser response. Overall survival at 5/10 years with PCR was 72.9% (95% CI: 64.4%-79.6%)/ 62.8% (53.0%-71.1%)/ event-free survival at 5 years 69.5% (60.9%-76.7%). Identified through cross-validation, key prognostic features included PCR, MPR, and treatment period following 18F-FDG-PET/CT-guided staging.Induction chemotherapy followed by chemo-radiotherapy results in high PCR rates. In this investigation, PCR is followed by high event-free and overall survival rates. These data warrant further investigation of chemo-radiotherapy as a significant component of neoadjuvant treatment regimens in trials combined with immunotherapy. This strategy may increase the PCR rates, particularly for patients with more advanced, potentially resectable stage III NSCLC.
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000306357 650_7 $$2Other$$ainduction chemo‐radiotherapy
000306357 650_7 $$2Other$$amajor pathological response
000306357 650_7 $$2Other$$apathologic complete response
000306357 650_7 $$2Other$$apotentially resectable stage III NSCLC
000306357 650_7 $$2Other$$apredictor of survival
000306357 650_2 $$2MeSH$$aHumans
000306357 650_2 $$2MeSH$$aCarcinoma, Non-Small-Cell Lung: pathology
000306357 650_2 $$2MeSH$$aCarcinoma, Non-Small-Cell Lung: mortality
000306357 650_2 $$2MeSH$$aCarcinoma, Non-Small-Cell Lung: therapy
000306357 650_2 $$2MeSH$$aCarcinoma, Non-Small-Cell Lung: drug therapy
000306357 650_2 $$2MeSH$$aMale
000306357 650_2 $$2MeSH$$aFemale
000306357 650_2 $$2MeSH$$aNeoadjuvant Therapy: methods
000306357 650_2 $$2MeSH$$aNeoadjuvant Therapy: mortality
000306357 650_2 $$2MeSH$$aLung Neoplasms: pathology
000306357 650_2 $$2MeSH$$aLung Neoplasms: mortality
000306357 650_2 $$2MeSH$$aLung Neoplasms: therapy
000306357 650_2 $$2MeSH$$aLung Neoplasms: drug therapy
000306357 650_2 $$2MeSH$$aInduction Chemotherapy: methods
000306357 650_2 $$2MeSH$$aMiddle Aged
000306357 650_2 $$2MeSH$$aAged
000306357 650_2 $$2MeSH$$aNeoplasm Staging
000306357 650_2 $$2MeSH$$aPrognosis
000306357 650_2 $$2MeSH$$aChemoradiotherapy: methods
000306357 650_2 $$2MeSH$$aPathologic Complete Response
000306357 7001_ $$0P:(DE-HGF)0$$aMetzenmacher, Martin$$b1
000306357 7001_ $$0P:(DE-HGF)0$$aPöttgen, Christoph$$b2
000306357 7001_ $$0P:(DE-HGF)0$$aWiesweg, Marcel$$b3
000306357 7001_ $$0P:(DE-HGF)0$$aGuberina, Nika$$b4
000306357 7001_ $$aMerkel-Jens, Anja$$b5
000306357 7001_ $$aLütke-Brintrup, Diana$$b6
000306357 7001_ $$aBölükbas, Servet$$b7
000306357 7001_ $$0P:(DE-HGF)0$$aEberhardt, Wilfried E E$$b8
000306357 7001_ $$aStamatis, Georgios$$b9
000306357 7001_ $$aDoerr, Fabian$$b10
000306357 7001_ $$aPlönes, Till$$b11
000306357 7001_ $$0P:(DE-HGF)0$$aHoffmann, Christian$$b12
000306357 7001_ $$0P:(DE-HGF)0$$aZaun, Gregor$$b13
000306357 7001_ $$0P:(DE-HGF)0$$aHöing, Benedikt$$b14
000306357 7001_ $$0P:(DE-HGF)0$$aKürten, Cornelius$$b15
000306357 7001_ $$aMladenov, Emil$$b16
000306357 7001_ $$aIliakis, George$$b17
000306357 7001_ $$0P:(DE-HGF)0$$aKersting, David$$b18
000306357 7001_ $$0P:(DE-HGF)0$$aFendler, Wolfgang P$$b19
000306357 7001_ $$0P:(DE-HGF)0$$aGauler, Thomas$$b20
000306357 7001_ $$aOpitz, Marcel$$b21
000306357 7001_ $$aMilosevic, Aleksandar$$b22
000306357 7001_ $$aForsting, Michael$$b23
000306357 7001_ $$aNensa, Felix$$b24
000306357 7001_ $$aUmutlu, Lale$$b25
000306357 7001_ $$0P:(DE-HGF)0$$aFunke, Faustina$$b26
000306357 7001_ $$0P:(DE-HGF)0$$aHautzel, Hubertus$$b27
000306357 7001_ $$0P:(DE-HGF)0$$aHerrmann, Ken$$b28
000306357 7001_ $$aTaube, Christian$$b29
000306357 7001_ $$0P:(DE-HGF)0$$aTheegarten, Dirk$$b30
000306357 7001_ $$aAigner, Clemens$$b31
000306357 7001_ $$0P:(DE-HGF)0$$aSchuler, Martin$$b32
000306357 7001_ $$0P:(DE-HGF)0$$aStuschke, Martin$$b33
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