Impact of chemoradiotherapy for first primary lung cancer on the prognosis and re-chemoradiotherapy sensitivity of second primary lung cancer
BackgroundDespite undergoing surgery and chemoradiotherapy, patients with first primary lung cancer (FPLC) remain at risk for second primary lung cancer (SPLC), which is associated with a poor prognosis. The effects of FPLC chemoradiotherapy on SPLC prognosis and its sensitivity to re-chemoradiother...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2025-01-01
|
| Series: | Frontiers in Immunology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2025.1492501/full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832584990923161600 |
|---|---|
| author | Zhe Chen Gaoming Wang Nan Wang Jiangjiang Liu Yu Yao Haitao Ma Haitao Ma Jing Luo Kai Xie |
| author_facet | Zhe Chen Gaoming Wang Nan Wang Jiangjiang Liu Yu Yao Haitao Ma Haitao Ma Jing Luo Kai Xie |
| author_sort | Zhe Chen |
| collection | DOAJ |
| description | BackgroundDespite undergoing surgery and chemoradiotherapy, patients with first primary lung cancer (FPLC) remain at risk for second primary lung cancer (SPLC), which is associated with a poor prognosis. The effects of FPLC chemoradiotherapy on SPLC prognosis and its sensitivity to re-chemoradiotherapy have not been adequately investigated.MethodsThis cohort study analyzed data from 23,827 patients who underwent FPLC surgery during 1973–2021, drawn from the Surveillance, Epidemiology, and End Results database. Among these, 5,302 FPLC patients developed SPLC within 5 years of their initial diagnosis. We employed the Fine-Gray competitive risk model, Cox proportional hazards model, and restricted mean survival time analysis to assess the effects of FPLC radiotherapy and chemotherapy on SPLC risk and survival differences.ResultsThe competitive risk model indicated that FPLC radiotherapy and chemotherapy did not significantly change the risk of developing SPLC. However, the Cox proportional hazards model revealed that FPLC radiotherapy was associated with decreased overall survival (OS; HR=1.251, P<0.001) and cancer-specific survival (CSS; HR=1.228, P=0.001) in patients with SPLC. Conversely, FPLC chemotherapy was linked to improved OS (HR=0.881, P=0.012) in this population. Patients with SPLC who received combined chemoradiotherapy for FPLC exhibited significantly reduced survival times (OS: HR=1.157, P=0.030; CSS: HR=1.198, P=0.018), a finding confirmed across multiple models. For SPLC patients with prior FPLC chemoradiotherapy, subsequent SPLC radiotherapy significantly improved prognosis. Notably, this benefit is even more pronounced in patients who have not received prior chemoradiotherapy. While SPLC chemotherapy enhanced OS for patients who did not receive FPLC chemotherapy, it was associated with reduced CSS for those who had.ConclusionsOverall, FPLC chemoradiotherapy influences SPLC prognosis and influences sensitivity to treatment. Tailoring SPLC management to FPLC treatment regimens may improve survival outcomes. |
| format | Article |
| id | doaj-art-4fe81acd05914a7b809f4f960645d290 |
| institution | Kabale University |
| issn | 1664-3224 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Immunology |
| spelling | doaj-art-4fe81acd05914a7b809f4f960645d2902025-01-27T06:40:57ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-01-011610.3389/fimmu.2025.14925011492501Impact of chemoradiotherapy for first primary lung cancer on the prognosis and re-chemoradiotherapy sensitivity of second primary lung cancerZhe Chen0Gaoming Wang1Nan Wang2Jiangjiang Liu3Yu Yao4Haitao Ma5Haitao Ma6Jing Luo7Kai Xie8Department of Cardiothoracic Surgery, The Fourth Affiliated Hospital of Soochow University, Suzhou, ChinaDepartment of Thoracic Surgery, Xuzhou Central Hospital, Clinical School of Xuzhou Medical University, Xuzhou, ChinaDepartment of Cardiothoracic Surgery, The Fourth Affiliated Hospital of Soochow University, Suzhou, ChinaDepartment of Cardiothoracic Surgery, The Fourth Affiliated Hospital of Soochow University, Suzhou, ChinaDepartment of Respiratory Medicine, Nanjing Second Hospital, Nanjing University of Chinese Medicine, Nanjing, ChinaDepartment of Cardiothoracic Surgery, The Fourth Affiliated Hospital of Soochow University, Suzhou, ChinaDepartment of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, ChinaDepartment of Cardiothoracic Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, ChinaDepartment of Cardiothoracic Surgery, The Fourth Affiliated Hospital of Soochow University, Suzhou, ChinaBackgroundDespite undergoing surgery and chemoradiotherapy, patients with first primary lung cancer (FPLC) remain at risk for second primary lung cancer (SPLC), which is associated with a poor prognosis. The effects of FPLC chemoradiotherapy on SPLC prognosis and its sensitivity to re-chemoradiotherapy have not been adequately investigated.MethodsThis cohort study analyzed data from 23,827 patients who underwent FPLC surgery during 1973–2021, drawn from the Surveillance, Epidemiology, and End Results database. Among these, 5,302 FPLC patients developed SPLC within 5 years of their initial diagnosis. We employed the Fine-Gray competitive risk model, Cox proportional hazards model, and restricted mean survival time analysis to assess the effects of FPLC radiotherapy and chemotherapy on SPLC risk and survival differences.ResultsThe competitive risk model indicated that FPLC radiotherapy and chemotherapy did not significantly change the risk of developing SPLC. However, the Cox proportional hazards model revealed that FPLC radiotherapy was associated with decreased overall survival (OS; HR=1.251, P<0.001) and cancer-specific survival (CSS; HR=1.228, P=0.001) in patients with SPLC. Conversely, FPLC chemotherapy was linked to improved OS (HR=0.881, P=0.012) in this population. Patients with SPLC who received combined chemoradiotherapy for FPLC exhibited significantly reduced survival times (OS: HR=1.157, P=0.030; CSS: HR=1.198, P=0.018), a finding confirmed across multiple models. For SPLC patients with prior FPLC chemoradiotherapy, subsequent SPLC radiotherapy significantly improved prognosis. Notably, this benefit is even more pronounced in patients who have not received prior chemoradiotherapy. While SPLC chemotherapy enhanced OS for patients who did not receive FPLC chemotherapy, it was associated with reduced CSS for those who had.ConclusionsOverall, FPLC chemoradiotherapy influences SPLC prognosis and influences sensitivity to treatment. Tailoring SPLC management to FPLC treatment regimens may improve survival outcomes.https://www.frontiersin.org/articles/10.3389/fimmu.2025.1492501/fullradiotherapychemotherapysecond primary lung cancerre-chemoradiotherapy sensitivityprognosis |
| spellingShingle | Zhe Chen Gaoming Wang Nan Wang Jiangjiang Liu Yu Yao Haitao Ma Haitao Ma Jing Luo Kai Xie Impact of chemoradiotherapy for first primary lung cancer on the prognosis and re-chemoradiotherapy sensitivity of second primary lung cancer Frontiers in Immunology radiotherapy chemotherapy second primary lung cancer re-chemoradiotherapy sensitivity prognosis |
| title | Impact of chemoradiotherapy for first primary lung cancer on the prognosis and re-chemoradiotherapy sensitivity of second primary lung cancer |
| title_full | Impact of chemoradiotherapy for first primary lung cancer on the prognosis and re-chemoradiotherapy sensitivity of second primary lung cancer |
| title_fullStr | Impact of chemoradiotherapy for first primary lung cancer on the prognosis and re-chemoradiotherapy sensitivity of second primary lung cancer |
| title_full_unstemmed | Impact of chemoradiotherapy for first primary lung cancer on the prognosis and re-chemoradiotherapy sensitivity of second primary lung cancer |
| title_short | Impact of chemoradiotherapy for first primary lung cancer on the prognosis and re-chemoradiotherapy sensitivity of second primary lung cancer |
| title_sort | impact of chemoradiotherapy for first primary lung cancer on the prognosis and re chemoradiotherapy sensitivity of second primary lung cancer |
| topic | radiotherapy chemotherapy second primary lung cancer re-chemoradiotherapy sensitivity prognosis |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2025.1492501/full |
| work_keys_str_mv | AT zhechen impactofchemoradiotherapyforfirstprimarylungcancerontheprognosisandrechemoradiotherapysensitivityofsecondprimarylungcancer AT gaomingwang impactofchemoradiotherapyforfirstprimarylungcancerontheprognosisandrechemoradiotherapysensitivityofsecondprimarylungcancer AT nanwang impactofchemoradiotherapyforfirstprimarylungcancerontheprognosisandrechemoradiotherapysensitivityofsecondprimarylungcancer AT jiangjiangliu impactofchemoradiotherapyforfirstprimarylungcancerontheprognosisandrechemoradiotherapysensitivityofsecondprimarylungcancer AT yuyao impactofchemoradiotherapyforfirstprimarylungcancerontheprognosisandrechemoradiotherapysensitivityofsecondprimarylungcancer AT haitaoma impactofchemoradiotherapyforfirstprimarylungcancerontheprognosisandrechemoradiotherapysensitivityofsecondprimarylungcancer AT haitaoma impactofchemoradiotherapyforfirstprimarylungcancerontheprognosisandrechemoradiotherapysensitivityofsecondprimarylungcancer AT jingluo impactofchemoradiotherapyforfirstprimarylungcancerontheprognosisandrechemoradiotherapysensitivityofsecondprimarylungcancer AT kaixie impactofchemoradiotherapyforfirstprimarylungcancerontheprognosisandrechemoradiotherapysensitivityofsecondprimarylungcancer |