PMID- 27206636
OWN - NLM
STAT- MEDLINE
DCOM- 20170711
LR  - 20181113
IS  - 1460-2105 (Electronic)
IS  - 0027-8874 (Print)
IS  - 0027-8874 (Linking)
VI  - 108
IP  - 9
DP  - 2016 Sep
TI  - Institutional Enrollment and Survival Among NSCLC Patients Receiving 
      Chemoradiation: NRG Oncology Radiation Therapy Oncology Group (RTOG) 0617.
LID - djw034 [pii]
LID - 10.1093/jnci/djw034 [doi]
AB  - BACKGROUND: The purpose of this analysis is to evaluate the effect of 
      institutional accrual volume on clinical outcomes among patients receiving 
      chemoradiation for locally advanced non-small cell lung cancer (LA-NSCLC) on a 
      phase III trial. METHODS: Patients with LA-NSCLC were randomly assigned to 60 Gy 
      or 74 Gy radiotherapy (RT) with concurrent carboplatin/paclitaxel +/- cetuximab 
      on NRG Oncology RTOG 0617. Participating institutions were categorized as 
      low-volume centers (LVCs) or high-volume centers (HVCs) according to the number 
      of patients accrued (</=3 vs > 3). All statistical tests were two-sided. RESULTS: 
      Range of accrual for LVCs (n = 195) vs HVCs (n = 300) was 1 to 3 vs 4 to 18 
      patients. Baseline characteristics were similar between the two cohorts. 
      Treatment at a HVC was associated with statistically significantly longer overall 
      survival (OS) and progression-free survival (PFS) compared with treatment at a 
      LVC (median OS = 26.2 vs 19.8 months; HR = 0.70, 95% CI = 0.56 to 0.88, P = .002; 
      median PFS: 11.4 vs 9.7 months, HR = 0.80, 95% CI = 0.65-0.99, P = .04). Patients 
      treated at HVCs were more often treated with intensity-modulated RT (54.0% vs 
      39.5%, P = .002), had a lower esophageal dose (mean = 26.1 vs 28.0 Gy, P = .03), 
      and had a lower heart dose (median = V5 Gy 38.2% vs 54.1%, P = .006; V50 Gy 3.6% 
      vs 7.3%, P < .001). Grade 5 adverse events (AEs) (5.3% vs 9.2%, P = .09) and RT 
      termination because of AEs (1.3% vs 4.1%, P = .07) were less common among 
      patients treated at HVCs. HVC remained independently associated with longer OS (P 
      = .03) when accounting for other factors. CONCLUSION: Treatment at institutions 
      with higher clinical trial accrual volume is associated with longer OS among 
      patients with LA-NSCLC participating in a phase III trial.
CI  - (c) The Author 2016. Published by Oxford University Press. All rights reserved. For 
      Permissions, please e-mail: journals.permissions@oup.com.
FAU - Eaton, Bree R
AU  - Eaton BR
AD  - Winship Cancer Institute of Emory University, Atlanta, GA (BRE, WJCJr); NRG 
      Oncology Statistics and Data Management Center, Philadelphia, PA (SLP); 
      Washington University School of Medicine, St. Louis, MO (JDB, CR); Christiana 
      Care/Helen Graham Medical Center, Newark, DE (GM); USON-Texas Oncology, 
      Sugarland, TX (VSK); Michigan Cancer Research Consortium, Ann Arbor, MI (SN); 
      University of Texas Southwestern Medical School, Dallas, TX (LN); University of 
      Pittsburgh Medical Center, Pittsburgh, PA (RBW); Christiana Care Health System, 
      Wilmington, DE (CK); Florida Radiation Oncology Group, Jacksonville, FL (DWJ); 
      The Ottawa Hospital, Ottawa, ON, Canada (JM) brupper@emory.edu.
FAU - Pugh, Stephanie L
AU  - Pugh SL
AD  - Winship Cancer Institute of Emory University, Atlanta, GA (BRE, WJCJr); NRG 
      Oncology Statistics and Data Management Center, Philadelphia, PA (SLP); 
      Washington University School of Medicine, St. Louis, MO (JDB, CR); Christiana 
      Care/Helen Graham Medical Center, Newark, DE (GM); USON-Texas Oncology, 
      Sugarland, TX (VSK); Michigan Cancer Research Consortium, Ann Arbor, MI (SN); 
      University of Texas Southwestern Medical School, Dallas, TX (LN); University of 
      Pittsburgh Medical Center, Pittsburgh, PA (RBW); Christiana Care Health System, 
      Wilmington, DE (CK); Florida Radiation Oncology Group, Jacksonville, FL (DWJ); 
      The Ottawa Hospital, Ottawa, ON, Canada (JM).
FAU - Bradley, Jeffrey D
AU  - Bradley JD
AD  - Winship Cancer Institute of Emory University, Atlanta, GA (BRE, WJCJr); NRG 
      Oncology Statistics and Data Management Center, Philadelphia, PA (SLP); 
      Washington University School of Medicine, St. Louis, MO (JDB, CR); Christiana 
      Care/Helen Graham Medical Center, Newark, DE (GM); USON-Texas Oncology, 
      Sugarland, TX (VSK); Michigan Cancer Research Consortium, Ann Arbor, MI (SN); 
      University of Texas Southwestern Medical School, Dallas, TX (LN); University of 
      Pittsburgh Medical Center, Pittsburgh, PA (RBW); Christiana Care Health System, 
      Wilmington, DE (CK); Florida Radiation Oncology Group, Jacksonville, FL (DWJ); 
      The Ottawa Hospital, Ottawa, ON, Canada (JM).
FAU - Masters, Greg
AU  - Masters G
AD  - Winship Cancer Institute of Emory University, Atlanta, GA (BRE, WJCJr); NRG 
      Oncology Statistics and Data Management Center, Philadelphia, PA (SLP); 
      Washington University School of Medicine, St. Louis, MO (JDB, CR); Christiana 
      Care/Helen Graham Medical Center, Newark, DE (GM); USON-Texas Oncology, 
      Sugarland, TX (VSK); Michigan Cancer Research Consortium, Ann Arbor, MI (SN); 
      University of Texas Southwestern Medical School, Dallas, TX (LN); University of 
      Pittsburgh Medical Center, Pittsburgh, PA (RBW); Christiana Care Health System, 
      Wilmington, DE (CK); Florida Radiation Oncology Group, Jacksonville, FL (DWJ); 
      The Ottawa Hospital, Ottawa, ON, Canada (JM).
FAU - Kavadi, Vivek S
AU  - Kavadi VS
AD  - Winship Cancer Institute of Emory University, Atlanta, GA (BRE, WJCJr); NRG 
      Oncology Statistics and Data Management Center, Philadelphia, PA (SLP); 
      Washington University School of Medicine, St. Louis, MO (JDB, CR); Christiana 
      Care/Helen Graham Medical Center, Newark, DE (GM); USON-Texas Oncology, 
      Sugarland, TX (VSK); Michigan Cancer Research Consortium, Ann Arbor, MI (SN); 
      University of Texas Southwestern Medical School, Dallas, TX (LN); University of 
      Pittsburgh Medical Center, Pittsburgh, PA (RBW); Christiana Care Health System, 
      Wilmington, DE (CK); Florida Radiation Oncology Group, Jacksonville, FL (DWJ); 
      The Ottawa Hospital, Ottawa, ON, Canada (JM).
FAU - Narayan, Samir
AU  - Narayan S
AD  - Winship Cancer Institute of Emory University, Atlanta, GA (BRE, WJCJr); NRG 
      Oncology Statistics and Data Management Center, Philadelphia, PA (SLP); 
      Washington University School of Medicine, St. Louis, MO (JDB, CR); Christiana 
      Care/Helen Graham Medical Center, Newark, DE (GM); USON-Texas Oncology, 
      Sugarland, TX (VSK); Michigan Cancer Research Consortium, Ann Arbor, MI (SN); 
      University of Texas Southwestern Medical School, Dallas, TX (LN); University of 
      Pittsburgh Medical Center, Pittsburgh, PA (RBW); Christiana Care Health System, 
      Wilmington, DE (CK); Florida Radiation Oncology Group, Jacksonville, FL (DWJ); 
      The Ottawa Hospital, Ottawa, ON, Canada (JM).
FAU - Nedzi, Lucien
AU  - Nedzi L
AD  - Winship Cancer Institute of Emory University, Atlanta, GA (BRE, WJCJr); NRG 
      Oncology Statistics and Data Management Center, Philadelphia, PA (SLP); 
      Washington University School of Medicine, St. Louis, MO (JDB, CR); Christiana 
      Care/Helen Graham Medical Center, Newark, DE (GM); USON-Texas Oncology, 
      Sugarland, TX (VSK); Michigan Cancer Research Consortium, Ann Arbor, MI (SN); 
      University of Texas Southwestern Medical School, Dallas, TX (LN); University of 
      Pittsburgh Medical Center, Pittsburgh, PA (RBW); Christiana Care Health System, 
      Wilmington, DE (CK); Florida Radiation Oncology Group, Jacksonville, FL (DWJ); 
      The Ottawa Hospital, Ottawa, ON, Canada (JM).
FAU - Robinson, Cliff
AU  - Robinson C
AD  - Winship Cancer Institute of Emory University, Atlanta, GA (BRE, WJCJr); NRG 
      Oncology Statistics and Data Management Center, Philadelphia, PA (SLP); 
      Washington University School of Medicine, St. Louis, MO (JDB, CR); Christiana 
      Care/Helen Graham Medical Center, Newark, DE (GM); USON-Texas Oncology, 
      Sugarland, TX (VSK); Michigan Cancer Research Consortium, Ann Arbor, MI (SN); 
      University of Texas Southwestern Medical School, Dallas, TX (LN); University of 
      Pittsburgh Medical Center, Pittsburgh, PA (RBW); Christiana Care Health System, 
      Wilmington, DE (CK); Florida Radiation Oncology Group, Jacksonville, FL (DWJ); 
      The Ottawa Hospital, Ottawa, ON, Canada (JM).
FAU - Wynn, Raymond B
AU  - Wynn RB
AD  - Winship Cancer Institute of Emory University, Atlanta, GA (BRE, WJCJr); NRG 
      Oncology Statistics and Data Management Center, Philadelphia, PA (SLP); 
      Washington University School of Medicine, St. Louis, MO (JDB, CR); Christiana 
      Care/Helen Graham Medical Center, Newark, DE (GM); USON-Texas Oncology, 
      Sugarland, TX (VSK); Michigan Cancer Research Consortium, Ann Arbor, MI (SN); 
      University of Texas Southwestern Medical School, Dallas, TX (LN); University of 
      Pittsburgh Medical Center, Pittsburgh, PA (RBW); Christiana Care Health System, 
      Wilmington, DE (CK); Florida Radiation Oncology Group, Jacksonville, FL (DWJ); 
      The Ottawa Hospital, Ottawa, ON, Canada (JM).
FAU - Koprowski, Christopher
AU  - Koprowski C
AD  - Winship Cancer Institute of Emory University, Atlanta, GA (BRE, WJCJr); NRG 
      Oncology Statistics and Data Management Center, Philadelphia, PA (SLP); 
      Washington University School of Medicine, St. Louis, MO (JDB, CR); Christiana 
      Care/Helen Graham Medical Center, Newark, DE (GM); USON-Texas Oncology, 
      Sugarland, TX (VSK); Michigan Cancer Research Consortium, Ann Arbor, MI (SN); 
      University of Texas Southwestern Medical School, Dallas, TX (LN); University of 
      Pittsburgh Medical Center, Pittsburgh, PA (RBW); Christiana Care Health System, 
      Wilmington, DE (CK); Florida Radiation Oncology Group, Jacksonville, FL (DWJ); 
      The Ottawa Hospital, Ottawa, ON, Canada (JM).
FAU - Johnson, Douglas W
AU  - Johnson DW
AD  - Winship Cancer Institute of Emory University, Atlanta, GA (BRE, WJCJr); NRG 
      Oncology Statistics and Data Management Center, Philadelphia, PA (SLP); 
      Washington University School of Medicine, St. Louis, MO (JDB, CR); Christiana 
      Care/Helen Graham Medical Center, Newark, DE (GM); USON-Texas Oncology, 
      Sugarland, TX (VSK); Michigan Cancer Research Consortium, Ann Arbor, MI (SN); 
      University of Texas Southwestern Medical School, Dallas, TX (LN); University of 
      Pittsburgh Medical Center, Pittsburgh, PA (RBW); Christiana Care Health System, 
      Wilmington, DE (CK); Florida Radiation Oncology Group, Jacksonville, FL (DWJ); 
      The Ottawa Hospital, Ottawa, ON, Canada (JM).
FAU - Meng, Joanne
AU  - Meng J
AD  - Winship Cancer Institute of Emory University, Atlanta, GA (BRE, WJCJr); NRG 
      Oncology Statistics and Data Management Center, Philadelphia, PA (SLP); 
      Washington University School of Medicine, St. Louis, MO (JDB, CR); Christiana 
      Care/Helen Graham Medical Center, Newark, DE (GM); USON-Texas Oncology, 
      Sugarland, TX (VSK); Michigan Cancer Research Consortium, Ann Arbor, MI (SN); 
      University of Texas Southwestern Medical School, Dallas, TX (LN); University of 
      Pittsburgh Medical Center, Pittsburgh, PA (RBW); Christiana Care Health System, 
      Wilmington, DE (CK); Florida Radiation Oncology Group, Jacksonville, FL (DWJ); 
      The Ottawa Hospital, Ottawa, ON, Canada (JM).
FAU - Curran, Walter J Jr
AU  - Curran WJ Jr
AD  - Winship Cancer Institute of Emory University, Atlanta, GA (BRE, WJCJr); NRG 
      Oncology Statistics and Data Management Center, Philadelphia, PA (SLP); 
      Washington University School of Medicine, St. Louis, MO (JDB, CR); Christiana 
      Care/Helen Graham Medical Center, Newark, DE (GM); USON-Texas Oncology, 
      Sugarland, TX (VSK); Michigan Cancer Research Consortium, Ann Arbor, MI (SN); 
      University of Texas Southwestern Medical School, Dallas, TX (LN); University of 
      Pittsburgh Medical Center, Pittsburgh, PA (RBW); Christiana Care Health System, 
      Wilmington, DE (CK); Florida Radiation Oncology Group, Jacksonville, FL (DWJ); 
      The Ottawa Hospital, Ottawa, ON, Canada (JM).
LA  - eng
GR  - U10 CA180868/CA/NCI NIH HHS/United States
GR  - UG1 CA189867/CA/NCI NIH HHS/United States
GR  - U10 CA037422/CA/NCI NIH HHS/United States
GR  - U10 CA021661/CA/NCI NIH HHS/United States
GR  - U10 CA180833/CA/NCI NIH HHS/United States
GR  - U10 CA180822/CA/NCI NIH HHS/United States
PT  - Clinical Trial, Phase III
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, N.I.H., Extramural
DEP - 20160519
PL  - United States
TA  - J Natl Cancer Inst
JT  - Journal of the National Cancer Institute
JID - 7503089
RN  - BG3F62OND5 (Carboplatin)
RN  - P88XT4IS4D (Paclitaxel)
RN  - PQX0D8J21J (Cetuximab)
SB  - IM
CIN - Nat Rev Clin Oncol. 2016 Nov;13(11):657-658. PMID: 27670233
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Antineoplastic Combined Chemotherapy Protocols/adverse effects/*therapeutic use
MH  - Carboplatin/administration & dosage
MH  - Carcinoma, Non-Small-Cell Lung/mortality/*therapy
MH  - Cetuximab/administration & dosage
MH  - Disease-Free Survival
MH  - Esophagus
MH  - Female
MH  - Heart
MH  - Hospitals, High-Volume/*statistics & numerical data
MH  - Hospitals, Low-Volume/*statistics & numerical data
MH  - Humans
MH  - Lung Neoplasms/mortality/*therapy
MH  - Male
MH  - Middle Aged
MH  - Organs at Risk
MH  - Paclitaxel/administration & dosage
MH  - Patient Selection
MH  - Radiotherapy Dosage
MH  - Radiotherapy, Intensity-Modulated/adverse effects
MH  - Survival Rate
PMC - PMC6059090
EDAT- 2016/05/22 06:00
MHDA- 2017/07/14 06:00
PMCR- 2017/05/19
CRDT- 2016/05/22 06:00
PHST- 2015/06/09 00:00 [received]
PHST- 2016/02/09 00:00 [accepted]
PHST- 2016/05/22 06:00 [entrez]
PHST- 2016/05/22 06:00 [pubmed]
PHST- 2017/07/14 06:00 [medline]
PHST- 2017/05/19 00:00 [pmc-release]
AID - djw034 [pii]
AID - 10.1093/jnci/djw034 [doi]
PST - epublish
SO  - J Natl Cancer Inst. 2016 May 19;108(9):djw034. doi: 10.1093/jnci/djw034. Print 
      2016 Sep.