Outcomes of Stereotactic Body Radiotherapy for T1-T2N0 Small Cell Carcinoma According to Addition of Chemotherapy and Prophylactic Cranial Irradiation: A Multicenter Analysis.
Outcomes of Stereotactic Body Radiotherapy for T1-T2N0 Small Cell Carcinoma According to Addition of Chemotherapy and Prophylactic Cranial Irradiation: A Multicenter Analysis.
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DOI：
10.1016/j.cllc.2017.03.009
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发表时间：
2017-11
影响因子：
3.6
通讯作者：
Lin SH
中科院分区：
文献类型：
--
作者：
Verma V;Simone CB 2nd;Allen PK;Lin SH
T1- 2N 0 SCLC很罕见，但通常与T1- 2N 0 NSCLC相似，仅用SBRT治疗。这项多中心研究评估了额外的化疗/PCI是否改善了结局。化疗改善了DFS和OS，并在多变量分析中预测了两者。PCI与本文的结局无统计学相关性。该分析表明，T1- 2N 0小细胞肺癌应视为有限阶段小细胞肺癌。尽管T1-2 N 0非小细胞肺癌（NSCLC）可以单独使用立体定向体部放疗（SBRT）进行治疗，但这种治疗通常外推用于T1-2 N 0小细胞肺癌（SCLC）。这项多机构队列研究调查了化疗和PCI是否改善了这些患者的结局。所有经组织学证实的T1-T2 N 0 M0 SCLC病例均来自24家机构前瞻性收集的SBRT数据库。评估了临床/治疗特征、毒性、结局和失败模式。Kaplan-Meier分析评价了生存结局。单变量和多变量分析确定了预后的预测因素。来自24家机构的74例患者的76处病变接受了治疗（中位随访时间为18个月）。分别有56%和23%的病例接受了化疗和预防性头颅放疗（PCI）。SBRT剂量/分次中位数为50戈伊/5次。接受化疗的患者中位DFS（61.3 vs. 9.0个月，p=0.02）和OS（31.4 vs. 14.3个月，p=0.02）增加。多变量分析显示，化疗可独立预测DFS/OS的更好结局（p=0.01）。毒性不常见; 5.2%发生≥2级肺炎。治疗后失败最常见的是远处（45.8%的复发），其次是淋巴结（25.0%）和肺其他部位（20.8%）。每次的中位时间在5-7个月之间。在迄今为止关于SBRT治疗T1- 2N 0 SCLC的最大报告中，接受原发性SBRT的患者还应接受额外的化疗。PCI在该人群中的作用尚未确定。
T1–2N0 SCLC is rare, but is often treated with SBRT alone similar to T1–2N0 NSCLC. This multi-center study assessed whether additional chemo/PCI improves outcomes. Chemotherapy improved DFS and OS and predicted for both on multivariate analysis. PCI was not statistically associated with outcomes herein. This analysis suggests that T1–2N0 SCLC should be treated as limited-stage SCLC. Whereas T1–2 N0 non-small cell lung cancer (NSCLC) can be managed with stereotactic body radiotherapy (SBRT) alone, this management is often extrapolated for T1–2 N0 small cell lung cancer (SCLC). This multi-institutional cohort study investigated whether addition of chemotherapy and PCI improved outcomes for these patients. All cases of histologically-confirmed T1-T2N0M0 SCLC were obtained from 24 institutions’ prospectively-collected SBRT databases. Clinical/treatment characteristics, toxicities, outcomes, and patterns of failure were assessed. Kaplan-Meier analysis evaluated survival outcomes. Univariate and multivariate analyses identified predictors of outcomes. From 24 institutions, 76 lesions were treated in 74 patients (median follow-up 18 months). Chemotherapy and prophylactic cranial irradiation (PCI) were delivered in 56% and 23% of cases, respectively. Median SBRT dose/fractionation was 50 Gy/5 fractions. Patients receiving chemotherapy experienced increased median DFS (61.3 vs. 9.0 months, p=0.02) and OS (31.4 vs. 14.3 months, p=0.02). Chemotherapy independently predicted better outcomes for DFS/OS on multivariate analysis (p=0.01). Toxicities were uncommon; 5.2% experienced grade ≥2 pneumonitis. Post-treatment failures were most commonly distant (45.8% of recurrences), followed by nodal (25.0%), and elsewhere lung (20.8%). Median times to each were between 5–7 months. In the largest report on SBRT for T1–2N0 SCLC to date, patients undergoing primary SBRT should also undergo additional chemotherapy. There is no established role of PCI in this population.
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影响因子：
5.3
作者：
Stahl, John M.;Corso, Christopher D.;Decker, Roy H.
通讯作者：
Decker, Roy H.
DOI：
10.1016/j.ijrobp.2016.11.049
发表时间：
2017-03-15
影响因子：
7
作者：
Verma, Vivek;Shostrom, Valerie K.;Simone, Charles B., II
通讯作者：
Simone, Charles B., II
影响因子：
6.2
作者：
Verma, Vivek;Shostrom, Valerie K.;Simone, Charles B., II
通讯作者：
Simone, Charles B., II
影响因子：
3.3
作者：
Videtic, Gregory M. M.;Stephans, Kevin L.;Djemil, Toufik
通讯作者：
Djemil, Toufik
DOI：
10.1016/j.ijrobp.2016.10.041
发表时间：
2017-02-01
影响因子：
7
作者：
Verma, Vivek;Simone, Charles B., II;Lin, Steven H.
通讯作者：
Lin, Steven H.