Weight Gain During Chemoradiotherapy is Associated with Prolonged Survival in Advanced Lung Cancer

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(ChemotherapyAdvisor) – Weight gain during chemoradiotherapy (CRT) for patients with advanced non–small-cell lung cancer (NSCLC) is associated with significantly prolonged survival, according to authors of a retrospective analysis published in Clinical Lung Cancer.

“Weight gain during definitive split-course CRT for stage III NSCLC is a strong prognostic factor for survival, although we do now know whether the (weight) gain in and of itself is favorable or whether it is instead serving as a reliable surrogate of response and favorable tumor biological characteristics,” reported a team of researchers at Rush University Medical Center in Chicago, IL, led by radiation oncologist David J. Sher, MD, MPH.

“In either case, this basic clinical sign may serve as an influential parameter in treatment decisions, because there is a fragile balance between treatment toxicity and benefit in this population and early and robust predictors of survival are critical for optimizing the therapeutic ratio,” they wrote. 

Weight gain during definitive split-course chemoradiotherapy was associated with superior overall survival (OS; 3-year difference, 55% vs 31%; hazard ratio = 0.5; 95% CI, 0.26-0.96; P=0.04) and prolonged distant metastasis-free survival (median DMFS, 24.6 vs. 14.3 months; P=0.02), the coauthors found.

The results suggest “systemic sensitivity to chemotherapy such that tumor-related anorexia improves during treatment,” they argued.

Patient weight gain “is an easily ascertainable prognostic factor that can risk-stratify patients and aid in decision making after treatment,” the coauthors concluded. “Assessing weight gain during treatment may provide early insight into tumor response” and offers a potential early indicator of combined-modality treatments in clinical trial settings, they wrote.


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