Swedish Lung Cancer Radiation Study Group: Predictive value of age at diagnosis for radiotherapy response in patients with non-small cell lung cancer

Figures & data

Table I. Patient characteristics, treatment and relapse.

	<55 years	55–64 years	65–74 years	≥75 years
Gender
Male	107 (48%)	222 (66%)	300 (71%)	126 (75%)
Female	115 (52%)	113 (34%)	122 (29%)	41 (25%)
Time period
1990–1995	101 (46%)	170 (51%)	212 (50%)	73 (44%)
1996–2000	117 (54%)	161 (49%)	208 (50%)	93 (56%)
Missing	4	4	2	1
Smoking status
Non-smoker	12 (6%)	16 (5%)	20 (5%)	8 (5%)
Ex-smoker	50 (24%)	127 (41%)	203 (51%)	87 (55%)
Current smoker	145 (70%)	168 (54%)	173 (44%)	63 (40%)
Missing	15	24	26	9
WHO performance status
0	84 (40%)	104 (33%)	115 (30%)	50 (32%)
1	112 (54%)	179 (57%)	229 (59%)	84 (55%)
2	12 (6%)	30 (10%)	40 (10%)	20 (13%)
3	1 (0.5%)	0 (0%)	2 (0.5%)	0 (0%)
Missing	13	22	36	13
Symptoms at presentation
Hoarseness	18 (8%)	20 (6%)	24 (6%)	7 (4%)
Haemoptysis	33 (15%)	67 (20%)	99 (23%)	42 (25%)
Thoracic pain	49 (22%)	61 (18%)	71 (17%)	15 (9%)
Pneumonia	36 (16%)	42 (13%)	58 (14%)	20 (12%)
Other	145 (65%)	195 (58%)	239 (57%)	110 (66%)
Histopathology
AC	76 (37%)	111 (34%)	109 (27%)	27 (17%)
SCC	83 (40%)	166 (51%)	241 (60%)	106 (68%)
Other	49 (24%)	47 (15%)	55 (14%)	24 (15%)
Missing	14	11	17	10
Stage
Ia	5 (3%)	6 (2%)	13 (4%)	11 (8%)
Ib	5 (3%)	12 (4%)	36 (10%)	22 (16%)
IIa	4 (2%)	4 (1%)	4 (1%)	1 (1%)
IIb	17 (9%)	32 (11%)	45 (13%)	23 (17%)
IIIa	41 (21%)	61 (21%)	86 (24%)	28 (21%)
IIIb	106 (56%)	157 (55%)	164 (46%)	48 (36%)
IV	13 (7%)	14 (5%)	10 (3%)	2 (1%)
Missing	31	49	64	32
Surgery
Yes	56 (31%)	76 (27%)	78 (22%)	16 (14%)
No	126 (69%)	206 (73%)	271 (78%)	102 (86%)
Missing	40	53	73	49
First line Chemotherapy^1
Yes	99 (45%)	132 (40%)	103 (25%)	14 (9%)
No	119 (55%)	194 (60%)	303 (75%)	144 (91%)
Missing	4	9	16	9
Second line Chemotherapy
Yes	50 (23%)	63 (19%)	40 (9%)	10 (6%)
No	172 (77%)	272 (81%)	382 (91%)	157 (94%)
Relapse
Yes	166 (83%)	238 (84%)	258 (77%)	91 (69%)
No	35 (17%)	45 (16%)	79 (23%)	40 (31%)
Missing	21	52	85	36
Cause of death
Lung cancer	147 (99%)	228 (94%)	260 (92%)	96 (87%)
Other	2 (1%)	14 (6%)	24 (8%)	14 (13%)
Missing	73	93	138	57

¹Induction and/or concomitant.

Figure 1. Overall survival for patients in different age groups at diagnosis.

Figure 2. Disease-specific survival for patients in different age groups at diagnosis.

Figure 3. Overall survival for different treatment combinations in patients aged <55 years.

Figure 4. Overall survival for different treatment combinations in patients aged 55–64 years.

Figure 5. Overall survival for different treatment combinations in patients aged 65–74 years.

Table IIa. Estimated overall survival for different subgroups.

Strata	N	Median overall survival (95% CI ), months	p-value, log-rank test	5-year survival rate, %	Standard error of survival rate
All patients	1146	14.7 (13.8–15.5)	–	9.5	0.0090
<55 years	222	15.8 (12.9–17.9)	p = 0.017	13.6	0.024
55–64 years	335	14.2 (12.5–16.1)		10.9	0.018
65–74 years	422	14.1 (12.6–15.0)		7.1	0.013
≥75 years	167	17.1 (14.2–19.0)		8.1	0.021
<55 years - stage I-II	31	25.1 (15.1–35.7)	p = 0.015	25.4	0.081
- stage III-IV	160	14.6 (11.8–14.6)		13.6	0.029
55–64 years - stage I-II	54	17.7 (11.2–21.9)	p = 0.96	9.8	0.041
- stage III-IV	232	13.7 (11.6–16.1)		12.8	0.023
65–74 years - stage I-II	98	14.5 (11.2–17.5)	p = 0.21	8.1	0.029
- stage III-IV	260	13.8 (11.6–15.0)		6.1	0.015
≥75 years - stage I-II	57	18.2 (12.0–21.0)	p = 0.91	8.8	0.038
- stage III-IV	78	17.6 (14.8–22.0)		6.4	0.028
<55 years - RT^1	72	11.2 (7.9–12.7)	p < 0.0001	4.9	0.026
- RT + chemo^2	52	14.6 (10.3–19.4)		15.1	0.050
- RT + surgery	38	28.0 (21.9–43.2)		25.9	0.073
- RT + chemo + surgery	17	42.8 (22.1–113.6)		31.5	0.116
55–64 years - RT	120	9.3 (7.6–11.3)	p < 0.0001	2.5	0.014
- RT + chemo	79	12.7 (10.8–16.1)		10.1	0.034
- RT + surgery	57	23.4 (16.6–29.1)		16.5	0.050
- RT + chemo + surgery	19	25.5 (14.2–34.6)		26.8	0.109
65–74 years - RT	204	12.0 (10.2–14.4)	p < 0.0001	2.9	0.012
- RT + chemo	62	13.9 (10.2–16.3)		1.6	0.016
- RT + surgery	60	16.8 (11.1–23.0)		15.9	0.048
- RT + chemo + surgery	16	35.4 (9.8–56.9)		25.0	0.108
≥75 years^3 - RT	91	17.1 (12.0–20.2)	p = 0.19	7.7	0.028
- RT + chemo	8	10.2 (6.3–19.7)		0.0	–
- RT + surgery	14	17.3 (5.6–29.2)		21.4	0.110

¹Radiation therapy.

²First line induction and/or concomitant chemotherapy.

³Only two patients received RT + chemotherapy + surgery.

Table IIb. Estimated disease-specific survival for different subgroups.

Strata	N	Median disease-specific survival (95%CI ), months	p-value, log-rank test	5-year survival rate, %	Standard error of survival rate
All patients	845	14.7 (13.7–15.8)	–	10.3	0.012
<55 years	169	15.6 (12.9–19.6)	p = 0.18	13.3	0.028
55–64 years	264	14.2 (12.2–16.5)		10.9	0.021
65–74 years	300	14.2 (12.8–15.9)		8.7	0.018
≥75 years	112	17.6 (13.1–21.6)		8.0	0.030

¹First line induction and/or concomitant chemotherapy.

Table III. Univariate Cox analyses of overall survival.

Variable	Number of patients	Hazard ratio (95% CI)	p-value
Total	1146
Gender
Female (ref.^1)	391
Male	755	1.09 (0.96–1.24)	0.18
Age
<55 years (ref.)	222
55–64 years	335	1.12 (0.94–1.34)	0.22
65–74 years	422	1.31 (1.10–1.55)	0.0024
≥75 years	167	1.19 (0.97–1.47)	0.10
Period
1990–1995 (ref.)	556
1996–2000	579	1.05 (0.93–1.18)	0.48
Missing	11
Smoking status
Non-smoker (ref.)	56
Ex-smoker	467	1.10 (0.82–1.45)	0.56
Current smoker	549	1.06 (0.80–1.41)	0.69
Missing	74
WHO performance status^2	1062	1.35 (1.22–1.49)	<0.0001
Missing	84
Histopathology
AC (ref.)	323
SCC	596	1.21 (1.05–1.40)	0.0074
Other	175	1.18 (0.97–1.43)	0.10
Missing	52
Stage^3	970	1.11 (1.06–1.16)	<0.0001
Missing	176
Surgery
No (ref.)	705
Yes	226	0.49 (0.42–0.58)	<0.0001
Missing	215
First line chemotherapy^4
No (ref.)	760
Yes	348	0.74 (0.65–0.85)	<0.0001
Missing	38
Second line chemotherapy
No (ref.)	983
Yes	163	0.83 (0.70–0.98)	0.028

¹Reference level for the respective variable.

²WHO performance status, grade 0–3.

³Stages IA, IB, IIA, IIB, IIIA, IIIB and IV were coded 1–7.

⁴Induction and/or concomitant.

Table IV. Multivariate Cox analysis of overall survival.

Variable	Hazard ratio (95% CI)	p-value
Gender
Female (ref.^1)
Male	0.91 (0.77–1.08)	0.26
Age
<55 years (ref.)
55–64 years	1.29 (1.02–1.62)	0.035
65–74 years	1.36 (1.08–1.71)	0.0097
≥75 years	1.02 (0.76–1.38)	0.90
WHO performance status^2	1.33 (1.17–1.52)	<0.0001
Histopathology
Adenocarinoma (ref.)
SCC	1.13 (0.94–1.36)	0.18
Other	1.26 (0.99–1.60)	0.062
Stage^3	1.09 (1.03–1.16)	0.0032
Surgery
No (ref.)
Yes	0.48 (0.39–0.59)	<0.0001
First line chemotherapy^3
No (ref.)
Yes	0.80 (0.67–0.97)	0.022
Second line chemotherapy
No (ref.)
Yes	0.69 (0.56–0.86)	0.0009

Model including gender, age at diagnosis. histopathology, stage, surgery, and first and second line chemotherapy.

Number of patients = 706.

Missing = 440.

¹Reference level for the respective variable.

²WHO performance status, grade 0 3.

³Stages IA, IB, IIA, IIB, IIIA, IIIB and IV were coded 1–7.

⁴Induction and/or concomitant.

Figure 6. Overall survival for different treatment combinations in patients aged ≥ 75 years.