Duration of twice-daily thoracic radiotherapy and time from the start of any treatment to the end of chest irradiation as significant predictors of outcomes in limited-disease small-cell lung cancer
Duration of twice-daily thoracic radiotherapy and time from the start of any treatment to the end of chest irradiation as significant predictors of outcomes in limited-disease small-cell lung cancer
复制标题
每日两次胸部放射治疗的持续时间以及从任何治疗开始到胸部放射结束的时间是有限疾病小细胞肺癌结果的重要预测因素
DOI：
10.1016/j.cllc.2016.09.004
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发表时间：
2017
影响因子：
3.6
通讯作者：
Atagi S
中科院分区：
文献类型：
--
作者：
Morimoto M;Okishio K;Akira M;Omachi N;Tamiya M;Asami K;Kawaguchi T;Atagi S
背景本回顾性研究的假设是，每天两次（BID）胸部放射治疗（TRT）的持续时间和从任何治疗开始到胸部放射治疗结束（SER）的时间可以预测局限性疾病小细胞肺癌的结局。结果放疗时间21-38 d，中位时间25 d。5年总生存率为26.2%（95%可信区间[CI]，14.3%-38.0%），中位生存时间为30个月（95% CI，15.5-44.5个月）。多因素回归分析显示，原发灶直径与转移淋巴结直径之和、男性、年龄≥ 60岁、BID-TRT持续时间是影响生存率的重要因素（风险比[HR]，1.15; 95% CI，1.06-1.25; HR，2.38; 95% CI，1.13-5.02; HR，2.38; 95% CI，1.10-5.17; HR，1.08; 95% CI，1.01-1.15）。81例患者中共有70例（86%）在第一个化疗周期接受了放疗。中位SER为29天（范围，21-109天）。5年局部控制率为48.7%（95%CI，33.9%~ 63.6%）。局部控制的显著预测因素是原发肿瘤和转移淋巴结直径之和、年龄≥ 60岁和SER（HR，1.18; 95% CI，1.06-1.31; HR，4.18; 95% CI，1.23-14.24;和HR，1.02;结论BID-TRT和SER的持续时间分别被确定为45戈伊/30次同步放化疗治疗局限性小细胞肺癌的生存和局部控制的重要预测因素之一。
BackgroundThe hypothesis of this retrospective study was that the duration of twice-daily (BID) thoracic radiotherapy (TRT) and time from the start of any treatment to the end of chest irradiation (SER) would predict outcomes in limited-disease small-cell lung cancer.Materials and MethodsAll 81 patients received 45 Gy in 30 fractions BID with a ≥ 6-hour interval and concurrent chemotherapy of platinum and etoposide.ResultsThe median radiotherapy duration was 25 days (range, 21-38 days). The 5-year overall survival rates were 26.2% (95% confidence interval [CI], 14.3%-38.0%), and the median survival time was 30 months (95% CI, 15.5-44.5 months). Using multivariate regression analysis, the significant predictors of survival were the sum of the diameters of the primary tumor and metastatic lymph nodes, male gender, age ≥ 60 years, and the duration of BID-TRT (hazard ratio [HR], 1.15; 95% CI, 1.06-1.25; HR, 2.38; 95% CI, 1.13-5.02; HR, 2.38; 95% CI, 1.10-5.17; and HR, 1.08; 95% CI, 1.01-1.15, respectively). A total of 70 of 81 patients (86%) received radiotherapy during the first chemotherapy cycle. The median SER was 29 days (range, 21-109 days). The 5-year local control rate was 48.7% (95% CI, 33.9%-63.6%). The significant predictors of local control were the sum of the diameters of the primary tumor and metastatic lymph nodes, age ≥ 60 years, and SER (HR, 1.18; 95% CI, 1.06-1.31; HR, 4.18; 95% CI, 1.23-14.24; and HR, 1.02; 95% CI, 1-1.04, respectively).ConclusionsThe duration of BID-TRT and SER were identified as one of the significant predictors of survival and local control in limited-disease small-cell lung cancer treated with concurrent chemoradiotherapy at 45 Gy in 30 fractions, respectively.