Survival inequalities in patients with lung cancer in France: A nationwide cohort study (the TERRITOIRE Study)

Background: Socio-economic position is associated with cancer incidence, but the direction and magnitude of this relationship differs across cancer types, geographical regions, and socio-economic parameters. In this nationwide cohort study, we evaluated the association between different individual-level socio-economic and -demographic factors, cancer incidence, and stage at diagnosis in Belgium. Methods: The 2001 census was linked to the nationwide Belgian Cancer Registry for cancer diagnoses between 2004 and 2013. Socio-economic parameters included education level, household composition, and housing conditions. Incidence rate ratios were assessed through Poisson regression models. Stage-specific analyses were conducted through logistic regression models. Results: Deprived groups showed higher risks for lung cancer and head and neck cancers, whereas an inverse relation was observed for malignant melanoma and female breast cancer. Typically, associations were more pronounced in men than in women. A lower socio-economic position was associated with reduced chances of being diagnosed with known or early stage at diagnosis; the strongest disparities were found for male lung cancer and female breast cancer. Conclusions: This study identified population groups at increased risk of cancer and unknown or advanced stage at diagnosis in Belgium. Further investigation is needed to build a comprehensive picture of socio-economic inequality in cancer incidence.

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Machine Learning Algorithm Guiding Local Treatment Decisions to Reduce Pain for Lung Cancer Patients with Bone Metastases, a Prospective Cohort Study

Pain and Therapy ◽

10.1007/s40122-021-00251-2 ◽

2021 ◽

Author(s):

Zhiyu Wang ◽

Jing Sun ◽

Yi Sun ◽

Yifeng Gu ◽

Yongming Xu ◽

...

Keyword(s):

Machine Learning ◽

Lung Cancer ◽

Cohort Study ◽

Bone Metastases ◽

Cancer Patients ◽

Prospective Cohort ◽

Learning Algorithm ◽

Local Treatment ◽

Machine Learning Algorithm ◽

Lung Cancer Patients

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Stereotactic Radiosurgery With and Without Checkpoint Inhibition for Patients with Metastatic Non-Small Cell Lung Cancer to the Brain: A Matched Cohort Study

Neurosurgery ◽

10.1093/neuros/nyz310_217 ◽

2019 ◽

Vol 66 (Supplement_1) ◽

Author(s):

Matthew Shepard ◽

Zhiyuan Xu ◽

Joseph Donahue ◽

Thomas Eluvathingal Muttikkal ◽

Diogo Codeiro ◽

...

Keyword(s):

Lung Cancer ◽

Cohort Study ◽

Small Cell Lung Cancer ◽

Radiation Necrosis ◽

Small Cell ◽

Tumor Control ◽

Peritumoral Edema ◽

Matched Cohort ◽

Small Cell Lung ◽

Intratumoral Hemorrhage

Abstract INTRODUCTION Immune checkpoint inhibitors (ICIs) improve survival in patients with advanced non-small cell lung cancer (NSCLC). Clinical trials examining the efficacy of ICI in patients with NSCLC excluded patients with untreated brain metastases (BM). As stereotactic radiosurgery (SRS) is commonly employed for NSCLC-BMs, we sought to define the safety, radiologic/clinical outcomes for patients with NSCLC-BM treated with concurrent ICI/SRS. METHODS A retrospective, matched cohort study was performed on patients who underwent SRS to one or more NSCLC-derived BM. Two matched cohorts were identified: one who received ICI within 3-mo of SRS (concurrent-ICI) and one who did not (ICI-naive). Locoregional tumor control, peritumoral edema, and central nervous system adverse events were compared. RESULTS A total of 17 patients (45-BMs) and 34 patients (92-BMs) comprised the concurrent-ICI and ICI-naive cohorts, respectively. Per RANO criteria, there was no difference in overall-survival (HR 0.99, 95% CI: 0.39-2.52) or CNS progression-free-survival (HR 2.18, 95% CI 0.72-6.62) between both groups. Similarly, the 12-mo local tumor control rate was 84.9% and 76.3% for tumors in the concurrent-ICI and ICI-naive cohorts, respectively (P = .94). Nevertheless, patients receiving concurrent-ICI had increased rates of complete response for BMs treated with SRS (50% vs 15.6%; P = .012) per RANO criteria. There was a shorter median time to BM regression in the concurrent-ICI cohort (2.5-mo vs 3.1-mo, P < .001). There was no increased rate of radiation necrosis or intratumoral hemorrhage in patients receiving concurrent-ICI (concurrent-ICI: 5.9%; ICI-naive: 2.9%, P = .99). There was no difference in the rate of peritumoral edema progression across both groups (concurrent-ICI: 11.1%, ICI-naive: 21.7%; P = .162). CONCLUSION The use of ICI/SRS to treat NSCLC-BM was well tolerated while providing more rapid BM regression. Concurrent-ICI did not increase rates of peritumoral edema, radiation necrosis, or intratumoral hemorrhage. Further studies are needed to evaluate whether concurrent ICI/SRS improves PFS/OS for patients with metastatic NSCLC.

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