In hindsight if treatment had begun early: A study to determine the OS and PFS in patients with stage III lung carcinoma based on the time elapsed from the diagnosis to start of treatment.
230 Background: Stage III non-small cell lung cancer (NSCLC) is defined as loco-regionally advanced disease due to primary tumor extension into the extra-pulmonary structures (T3 or T4) or mediastinal lymph node involvement (N2 or N3) without evidence of distant metastasis. Patients are concerned about beginning treatment early after diagnosis. The role of the study is to determine the outcome if treatment is started within 8 weeks or after 8 weeks. In a retrospective study, the Cleveland Clinic’s database was used to identify patients treated through 2003 – 2014. Methods: Stage III NSCLC was ascertained as per the pathological or clinical stage. Kaplan-Meier estimate was used to determine the survival of patients. Results: Of the 561 patients patients with stage III NSCLC, 408 had treatment within 8 weeks and 153 after 8 weeks. See table. Treatment within 8 weeks of diagnosis: In total, 105 patients were recorded as having died, the median survival was 55.1 months (95% CI: 48.2, 62.5). The 2-year survival rate was 98% ± 0.9%, and the 5-year survival rate was 44.5% ± 4.7%. The median PFS was 15.3 months (95%Ci 12.0, 23.1). The 2-year PFS was 43% ± 0.28%, and the 5-year PFS was 14.5% ± 2.1%. Treatment after 8 weeks of diagnosis: In total, 34 patients were recorded as having died, the median survival was 60.6 months (95% CI: 50.3, 73.8). The 2-year survival rate was 97.5% ± 1.4%, and the 5-year survival rate was 53.2% ± 8.3%. The median PFS was 12.1 months (95%Ci 9.5, 15.3). The 2-year PFS was 32.8% ± 4.4%, and the 5-year PFS was 12.8% ± 3.2%. Among the following sub-groups: < 65 years, 65-75 years and > 75 years, there was no observable difference whether treatment was begun within eight weeks or after eight weeks. Conclusions: In the combined group and within subgroups, OS and PFS were not significantly different between patients who received treatment within 8 weeks and those who received treatment after 8 weeks. [Table: see text]