Treatment Outcomes and Prognostic Factors of Patients with Locally Advanced Non-Small Cell Lung Cancer: A Single Institution Study

Background: Lung cancer is the second most common cancer globally. Non-small cell lung cancer (NSCLC) is the most common pathological type. One third of patients present with locally advanced disease. Objective: The retrospective study aims to assess prognostic factors and survival outcomes in locally advanced NSCLC patients. Patients and Methods: 101 patients, with locally advanced NSCLC registered in the Clinical Oncology and Nuclear Medicine Department, Mansoura University between January 2011 and December 2021, were included. Results: Mean age of patients was 59 years. The majority were males (83.2%). Most common pathologies were squamous cell carcinoma (47.5 %) and adenocarcinoma (41.6%). All patients were stage III except for 4% with unresectable stage IIB. Thirty-six cases (35.7%) received concurrent chemoradiotherapy (CCRT). Others underwent surgery or received chemotherapy only. Median overall survival (OS) was 9 months. Patients who received CCRT had higher OS (p-value 0.019) and progression free survival (PFS) (<0.001), compared to those who did not. Induction chemotherapy did not affect survival. Radiotherapy (RT) interruption was a statistically significant negative prognostic factor (p-value <0.001). Age of 60 years or above, weight loss, squamous histology, cisplatin-based regimens, and number of cycles were found to be prognostic factors affecting survival on both univariate and multivariate analysis. Conclusion: CCRT with cisplatin-based chemotherapy remains the superior line of treatment in patients with locally advanced NSCLC.