Evaluation of factors associated with loco-regional failure and survival in limited XXXX @entity1 treated with chemoradiotherapy.

@entity1 @entity137 @entity4153 @entity7184 @entity3003 @entity900 @entity2879 @entity177 @entity151 @entity1349
BACKGROUND: @entity177 ( @entity177 ) remains a significant problem in limited @entity151 (LD- @entity4153 ) @entity1 treated with definitive chemoradiotherapy. Dose-escalation may be a way forward to reduce the failure rate. However, the risk of @entity137 rises with increasing doses. Knowledge on factors associated with @entity177 could aid the selection of @entity1 for more aggressive treatment. Therefore, the aim of this study is to evaluate factors correlated with @entity177 in a cohort of LD- @entity4153 @entity1 treated with definitive chemoradiotherapy. Moreover, factors associated with improved survival were investigated. MATERIAL AND METHODS: We included 147 consecutive LD- @entity4153 @entity1 treated from 2007 to 2013. Radiotherapy was delivered as either 45 Gy in 1.5-Gy fractions twice daily or 46-50 Gy in 2-Gy fractions once daily. Chemotherapy was @entity2879 combined with either @entity3003 or @entity900 given mainly concomitantly with radiotherapy. Pattern of first failure and survival were evaluated retrospectively. @entity7184 ( @entity7184 ) and @entity1349 ( @entity1349 ) were calculated by the Kaplan-Meier method. The impact of covariates on @entity177 and @entity1349 was evaluated by using Cox proportional hazards model. RESULTS: With a median follow-up time of 42.2 months, 37 @entity1 experienced @entity177 as first failure. Isolated @entity177 was seen in 16 @entity1 , but no isolated regional failure was seen. The @entity7184 rate was 22% at 1-year and 43% at 3-years. N3-stage was an independent prognostic factor correlated with @entity177 development (p = 0.043). Median @entity1349 was 24.1 months (95% CI 19-29 months) and a three-year survival of 34%. Prognostic factors associated with improved @entity1349 were staging including a positron emission tomography (PET) scan (p = 0.004) and receiving prophylactic cranial irradiation (PCI) (p = 0.006). CONCLUSION: N3-stage was an independent prognostic factor for @entity177 . Receiving a pretreatment PET scan and receiving PCI were prognostic factors for improved @entity1349 . Reduction in @entity177 may be achieved with dose-escalation in @entity1 with N3-stage. This can be evaluated in prospective dose-escalation trials.
