Chest Tube Drainage, Bone Radiotherapy, and Brain Radiotherapy in Advanced Lung Cancer - A Retrospective Analysis of Associated Factors and Survival

Sep 23, 2026

Uploaded by James

Palliative interventions, including chest tube drainage and radiotherapy for bone and brain metastases, are essential for managing survival and quality of life in advanced lung cancer. This retrospective analysis evaluated 8171 unresectable Stage IV patients from the Japanese Joint Committee of Lung Cancer Registry (JJCLCR) database. Treatment initiation rates were 8.6% for chest tube drainage, 9.9% for bone radiotherapy, and 11.5% for brain radiotherapy. Associated factors for each intervention were identified and linked to overall survival outcomes.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages11

Reading Time28 min

AccessFree to download

Introduction

Methods

Results

Conclusion

Thoracic Cancer ORIGINAL ARTICLE OPEN ACCESS Chest Tube Drainage, Bone Radiotherapy, and Brain Radiotherapy in Advanced Lung Cancer: A Retrospective Analysis of Associated Factors and Survival Shoko Sonobe Shimamura1 | Takehito Shukuya1 | Kazuhisa Takahashi1 | Yasushi Shintani2 | Ikuo Sekine3 | Koichi Takayama4 | Akira Inoue5 | Isamu Okamoto6 | Tomoya Kawaguchi7 | Nobuyuki Yamamoto8 | Etsuo Miyaoka9 | Ichiro Yoshino10 | Hiroshi Date11 1Department of Respiratory Medicine, Juntendo University, Tokyo, Japan | 2Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan | 3Department of Medical Oncology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan | 4Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan | 5Department of Palliative Medicine, Tohoku University School of Medicine, Sendai, Miyagi, Japan | 6Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan | 7Department of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan | 8Internal Medicine III, Wakayama Medical University, Wakayama, Japan | 9Department of Mathematics, Tokyo University of Science, Tokyo, Japan | 10Department of General Thoracic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan | 11Department of Thoracic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan Correspondence: Takehito Shukuya ([tshukuya@juntendo.ac.jp](tshukuya@juntendo.ac.jp)) Received: 8 September 2024 | Revised: 20 March 2025 | Accepted: 24 March 2025 Keywords: associated factors | chest tube drainage | lung cancer | palliative care | radiotherapy ABSTRACT Background: Palliative interventions, such as chest tube drainage and radiotherapy for bone and brain metastases, are crucial for managing survival and quality of life in patients with advanced lung cancer. Methods: This retrospective study analyzed 8171 patients with unresectable Stage IV lung cancer from the Japanese Joint Committee of Lung Cancer Registry (JJCLCR) database. At treatment initiation, 8.6% of patients underwent chest tube drainage, 9.9% underwent bone radiotherapy, and 11.5% underwent brain radiotherapy. In this study, associated factors for palliative interventions were evaluated, and their impact on patient survival was also assessed. Results: High-associated factors for upfront chest tube drainage included age ≥75years, ECOG-PS ≥2, pleural nodules, andadenocarcinoma, while EGFR mutation, serum albumin ≥3.2 mg/dL, adrenal gland, and brain metastases were low-associated factors. For upfront brain radiotherapy, low-associated factors included malignant pleural effusion (MPE) and bone metastases, whereas ECOG-PS ≥2 was a high-associated factor. High-associated factors for upfront bone radiotherapy were serum albumin ≥3.2 mg/dL, ECOG-PS ≥2, adenocarcinoma, and squamous cell carcinoma, while pleural nodules, MPE, liver, and brain metastasis were low-associated factors. Patients receiving upfront bone radiotherapy had shorter survival, whereas survival did not significantly differ for those with or without upfront chest tube drainage or brain radiotherapy. Conclusion: This study identified associated factors for palliative interventions in advanced lung cancer and their association with overall survival. Future prospective studies with more detailed data are necessary to confirm these findings and improve clinical decision-making. Trial Registration: Approval No. 15,321 This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. © 2025 The Author(s) . Thoracic Cancer published by John Wiley & Sons Australia, Ltd. Thoracic Cancer, 2025; 16:e70060 1 of 11 [http

FAQs

What palliative interventions were assessed in advanced lung cancer?

The study assessed chest tube drainage and radiotherapy for bone and brain metastases as palliative interventions.

How many patients were included, and what stage was analyzed?

The retrospective cohort included 8,171 patients with unresectable Stage IV lung cancer from the JJCLCR database.

Which interventions showed shorter survival in the study?

Patients receiving upfront bone radiotherapy had shorter survival, while survival did not significantly differ for those with or without upfront chest tube drainage or brain radiotherapy.

Sep 23, 2026

Uploaded by James