Difference in failure patterns after stereotactic body radiotherapy for lung cancer according to the clinical T stage based on 4D computed tomography
Difference in failure patterns after stereotactic body radiotherapy for lung cancer according to the clinical T stage based on 4D computed tomography
复制标题
根据基于4D计算机断层扫描的临床T分期，肺癌立体定向放疗后失败模式的差异
DOI：
10.1007/s00066-022-02030-0
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发表时间：
2023
影响因子：
3.1
通讯作者：
Nishimura Y
中科院分区：
文献类型：
--
作者：
Inagaki T;Doi H;Inada M;Ishida N;Ri A;Tatsuno S;Wada Y;Uehara T;Nakamatsu K;Hosono M;Nishimura Y
目的立体定向全身放射治疗 (SBRT) 是早期肺癌的一种治疗选择。我们的目的是根据临床 T 分期检查 SBRT 后失败模式的差异。方法对总共 120 例接受 SBRT 的早期肺癌 (T1-3N0M0) 患者进行分析。使用四维计算机断层扫描（4D-CT）确认肿瘤与胸壁接触的患者的临床分期。从临床图表中证实了局部失败、区域淋巴结转移和远处转移。结果 SBRT 后中位随访时间为 27.5 个月（范围 7-122）。使用 4D-CT 分析将 13 名患者从临床 T2 内脏胸膜侵犯重新分期为 T3 胸壁侵犯。 37 名患者出现复发。中位无进展生存期 (PFS) 和总生存期 (OS) 分别为 38.1 个月和 53.8 个月。 3 年 PFS 和 OS 率分别为 50.7% 和 60.3%。根据临床 T 分期，观察到 PFS 存在显着差异 (p= 0.001)。根据临床 T 分期，OS 没有观察到显着差异 (p= 0.213)。随着从 T1 进展到 T3，局部区域失败相对于远处转移的比例下降。 T3 肿瘤的胸膜播散率显着高于 T1 和 T2 肿瘤 (p= 0.010)。 结论 临床 T 分期与肺癌 SBRT 后的 PFS 相关。根据 T 阶段，故障模式存在差异。 4D-CT 可能为评估与不良 PFS 相关的胸壁侵犯提供重要信息。
PurposeStereotactic body radiotherapy (SBRT) is a treatment option for early-stage lung cancer. We aimed to examine the differences in failure patterns after SBRT according to the clinical T stage.MethodsA total of 120 patients with early-stage lung cancer (T1-3N0M0) who underwent SBRT were analysed. The clinical stage in patients whose tumours were in contact with the chest wall was confirmed using four-dimensional computed tomography (4D-CT). Local failure, regional node metastasis, and distant metastasis were confirmed from clinical charts.ResultsMedian follow-up time was 27.5 months (range 7–122) after SBRT. Thirteen patients were restaged from clinical T2 with visceral pleural invasion to T3 with chest wall invasion using 4D-CT analysis. Thirty-seven patients developed recurrences. The median progression-free survival (PFS) and overall survival (OS) were 38.1 and 53.8 months, respectively. The 3‑year PFS and OS rates were 50.7% and 60.3%, respectively. A significant difference was observed in PFS according to the clinical T stage (p= 0.001). No significant differences were observed in OS according to the clinical T stage (p= 0.213). The proportion of locoregional failures relative to distant metastasis decreased with progression from T1 to T3. The pleural dissemination rate was significantly higher in T3 tumours than in T1 and T2 tumours (p= 0.010).ConclusionClinical T stage is associated with PFS after SBRT for lung cancer. There were differences in the failure patterns according to T stage. 4D-CT might provide significant information for assessing chest wall invasion associated with unfavourable PFS.