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Background <p>Concurrent chemoradiotherapy (cCRT) is a pivotal component in locally advanced non-small cell lung cancer (NSCLC) treatment; however, exploration of factors that impact its efficacy has been limited.</p> Methods <p>We analyzed individual data of 1165 patients with locally advanced NSCLC enrolled in randomized phase II/III trials of cCRT between 1999 and 2016. Least absolute shrinkage and selection operator (LASSO) regression was applied to identify factors associated with 3-year progression-free survival (PFS). Cox regression was applied to adjust for key clinical variables.</p> Results <p>The 3- and 5-year PFS rates were 19.7% and 14.3%, respectively (median PFS: 9.7 months). The 3- and 5-year overall survival rates were 56.7% and 42.9%, respectively (median OS: 25.7 months). LASSO regression identified age, lower lobe tumor location, weight loss (≥5% within 6 months), smoking index, and histology as predictors of PFS. Lower lobe tumors and weight loss independently predicted shorter PFS (lower lobe: hazard ratio 1.29; 95% CI, 1.02–1.64; <i>P</i> = 0.036). Lower lobe tumors also had more pneumonitis (55.8% vs. 43.4%; grade ≥3: 11.0% vs. 4.3%) and in-field recurrence (60.2% vs. 51.4%).</p> Conclusion <p>Primary tumor location should be carefully considered in clinical practice and during the development of treatment strategies for locally advanced NSCLC.</p>

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Impact of tumor location on the efficacy of concurrent chemoradiotherapy for locally advanced non-small cell lung cancer

  • 期刊论文

  • 发表日期：

    2026年4月9日

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  • Yuichi Ozawa,
  • Kouji Yamamoto,
  • Shunichi Sugawara,
  • Seiji Niho,
  • Hiroaki Okamoto,
  • Katsuyuki Hotta,
  • Isamu Okamoto,
  • Norihiko Ikeda,
  • Nobuyuki Yamamoto

摘要

Background

Concurrent chemoradiotherapy (cCRT) is a pivotal component in locally advanced non-small cell lung cancer (NSCLC) treatment; however, exploration of factors that impact its efficacy has been limited.

Methods

We analyzed individual data of 1165 patients with locally advanced NSCLC enrolled in randomized phase II/III trials of cCRT between 1999 and 2016. Least absolute shrinkage and selection operator (LASSO) regression was applied to identify factors associated with 3-year progression-free survival (PFS). Cox regression was applied to adjust for key clinical variables.

Results

The 3- and 5-year PFS rates were 19.7% and 14.3%, respectively (median PFS: 9.7 months). The 3- and 5-year overall survival rates were 56.7% and 42.9%, respectively (median OS: 25.7 months). LASSO regression identified age, lower lobe tumor location, weight loss (≥5% within 6 months), smoking index, and histology as predictors of PFS. Lower lobe tumors and weight loss independently predicted shorter PFS (lower lobe: hazard ratio 1.29; 95% CI, 1.02–1.64; P = 0.036). Lower lobe tumors also had more pneumonitis (55.8% vs. 43.4%; grade ≥3: 11.0% vs. 4.3%) and in-field recurrence (60.2% vs. 51.4%).

Conclusion

Primary tumor location should be carefully considered in clinical practice and during the development of treatment strategies for locally advanced NSCLC.