Prognostic impact of radiation therapy to the primary tumor in patients with non-small cell lung cancer and oligometastasis at diagnosis.
Prognostic impact of radiation therapy to the primary tumor in patients with non-small cell lung cancer and oligometastasis at diagnosis.
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DOI：
10.1016/j.ijrobp.2012.02.054
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发表时间：
2012-09-01
影响因子：
7
通讯作者：
Liao, Zhongxing
中科院分区：
文献类型：
--
作者：
Lopez Guerra, Jose Luis;Gomez, Daniel;Zhuang, Yan;Hong, David S.;Heymach, John V.;Swisher, Stephen G.;Lin, Steven H.;Komaki, Ritsuko;Cox, James D.;Liao, Zhongxing
我们研究了与诊断时的非小细胞肺癌（NSCLC）和寡转移性疾病患者的生存相关的预后因素，特别是对原发部位的局部治疗对预后的影响。从2000年1月至2011年6月，78例诊断为寡转移性NSCLC（<5个转移灶）的连续患者接受了原发部位的确定性放化疗（≥45戈伊）。其中44例患者还接受了针对寡转移的明确局部治疗。采用Kaplan-Meier法估计生存结局，并通过单变量和多变量分析确定风险因素。单变量考克斯比例风险分析显示，原发部位接受至少63戈伊放疗的患者总生存率（OS）更高（P=.002），接受明确的局部治疗以治疗寡转移（P=.041），Karnofsky体能状态（KPS）评分>80（P= 0.007），肿瘤体积≤ 124 cm 3（P= 0.002），组织学类型为腺癌（P= 0.002），或无呼吸系统疾病史（P= 0.016）。在多变量分析中，放射剂量、体能状态和肿瘤体积保持显著性（分别为P=.004、P=.006和P<.001）。当分别分析有和无脑转移的患者时，放射剂量也保持显著性。肿瘤体积、KPS和原发肿瘤接受至少63戈伊治疗与诊断时寡转移性NSCLC患者的OS改善相关。我们的研究结果表明，这些患者的一个子集可能受益于明确的局部治疗。
We investigated prognostic factors associated with survival in patients with non-small cell lung cancer (NSCLC) and oligometastatic disease at diagnosis, particularly the influence of local treatment to the primary site on prognosis. From January 2000 through June 2011, 78 consecutive patients with oligometastatic NSCLC (<5 metastases) at diagnosis underwent definitive chemoradiation therapy (≥45 Gy) to the primary site. Forty-four of these patients also received definitive local treatment for the oligometastases. Survival outcomes were estimated using the Kaplan-Meier method, and risk factors were identified by univariate and multivariate analyses. Univariate Cox proportional hazard analysis revealed better overall survival (OS) for those patients who received at least 63 Gy of radiation to the primary site (P=.002), received definitive local treatment for oligometastasis (P=.041), had a Karnofsky performance status (KPS) score >80 (P=.007), had a gross tumor volume ≤ 124 cm3 (P=.002), had adenocarcinoma histology (P=.002), or had no history of respiratory disease (P=.016). On multivariate analysis, radiation dose, performance status, and tumor volume retained significance (P=.004, P=.006, and P<.001, respectively). The radiation dose also maintained significance when patients with and without brain metastases were analyzed separately. Tumor volume, KPS, and receipt of at least 63 Gy to the primary tumor are associated with improved OS in patients with oligometastatic NSCLC at diagnosis. Our results suggest that a subset of such patients may benefit from definitive local therapy.
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DOI：
10.1016/j.ijrobp.2005.02.010
发表时间：
2005-10-01
影响因子：
7
作者：
Kong, FM;Ten Haken, RK;Hayman, JA
通讯作者：
Hayman, JA
影响因子：
2.5
作者：
Yano, Tokujiro;Haro, Akira;Maehara, Yoshihiko
通讯作者：
Maehara, Yoshihiko
影响因子：
45.3
作者：
Tanvetyanon, Tawee;Robinson, Lary A.;Bepler, Gerold
通讯作者：
Bepler, Gerold
影响因子：
6.2
作者：
Lind, Joline S. W.;Lagerwaard, Frank J.;Senan, Suresh
通讯作者：
Senan, Suresh
影响因子：
45.3
作者：
Yuan, Xianglin;Liao, Zhongxing;Wei, Qingyi
通讯作者：
Wei, Qingyi