Higher biologically effective dose of radiotherapy is associated with improved outcomes for locally advanced non-small cell lung carcinoma treated with chemoradiation: an analysis of the Radiation Therapy Oncology Group.
Higher biologically effective dose of radiotherapy is associated with improved outcomes for locally advanced non-small cell lung carcinoma treated with chemoradiation: an analysis of the Radiation Therapy Oncology Group.
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DOI：
10.1016/j.ijrobp.2010.09.004
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发表时间：
2012-01-01
期刊：
影响因子：
--
通讯作者：
Curran WJ
中科院分区：
文献类型：
--
作者：
Machtay M;Bae K;Movsas B;Paulus R;Gore EM;Komaki R;Albain K;Sause WT;Curran WJ
分析接受放化疗治疗的局部晚期非小细胞肺癌（LA-NSCLC）患者的局部区域失败（LRF）和总生存期（OS）与放疗剂量强度（BED）的关系。本研究合并了来自7项放疗肿瘤组（RTOG）试验的数据，这些试验使用放化疗治疗LA NSCLC：RTOG 88-08（仅放化疗组）、90-15、91-06、92-04、93-09（仅非手术组）、94-10和98-01。使用标准公式计算每例患者接受的放射性生物有效剂量（BED），以及总体治疗时间校正的BED（tBED）。使用卡方统计进行异方差检验，并使用加权合并风险比估计值。OS和LRF分别采用考克斯和Fine和Gray比例风险模型，以检验调整其他协变量后的BED/tBED之间的相关性。共分析了1，356例患者的BED（1，348例tBED）。2年和5年OS率分别为38%和15%。2年和5年LRF率分别为46%和52%。在多变量分析中，BED（和tBED）与OS和LRF高度显著相关（p<0.0001）。放射治疗剂量强度增加1戈伊BED与生存期相对改善约4%具有统计学显著性相关-这是另一种表达结果的方式，即作为BED的函数，合并校正的生存期HR为0.96。类似地，放疗剂量强度增加1戈伊tBED与局部区域控制的约3%相对改善具有统计学显著性相关-这是另一种表达结果的方式，即作为tBED的函数的合并校正HR为0.97。较高的放射治疗剂量强度与改善的局部区域控制和生存在设置的化学放射治疗。
Patients treated with chemoradiotherapy for locally advanced non-small-cell lung carcinoma (LA-NSCLC) were analyzed for local-regional failure (LRF) and overall survival (OS) with respect to radiotherapy dose intensity (BED). This study combined data from seven Radiation Therapy Oncology Group (RTOG) trials in which chemoradiotherapy was used for LA NSCLC: RTOG 88-08 (chemoradiation arm only), 90-15, 91-06, 92-04, 93-09 (nonoperative arm only), 94-10 and 98-01. The radiotherapeutic biologically effective dose (BED) received by each individual patient was calculated, as was the overall treatment time-adjusted BED (tBED) using standard formulae. Heterogeneity testing was done with Chi-squared statistics and weighted pooled hazard ratio estimates were used. Cox and Fine and Gray's proportional hazard models were used for OS and LRF, respectively, to test the associations between BED/tBED adjusted for other covariates. A total of 1,356 patients were analyzed for BED (1,348 for tBED). The 2-year and 5-year OS rates were 38% and 15%. The 2-year and 5-year LRF rates were 46% and 52%. BED (and tBED) were highly significantly associated with both OS and LRF, with or without adjustment for other covariates on multivariate analysis (p<0.0001). A 1 Gy BED increase in radiotherapy dose intensity was statistically significantly associated with approximately 4% relative improvement in survival – this is another way of expressing the finding that the pool adjusted HR for survival as a function of BED was 0.96. Similarly, a 1 Gy tBED increase in radiotherapy dose intensity was statistically significantly associated with approximately 3% relative improvement in local-regional control – this is another way of expressing the finding that the pool adjusted HR as a function of tBED was 0.97. Higher radiotherapy dose intensity is associated with improved local-regional control and survival in the setting of chemoradiotherapy.
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DOI：
10.1093/jnci/88.17.1210
发表时间：
1996-09-04
期刊：
JOURNAL OF THE NATIONAL CANCER INSTITUTE
影响因子：
--
作者：
Dillman, RO;Herndon, J;Green, MR
通讯作者：
Green, MR
影响因子：
168.9
作者：
Albain, Kathy S.;Swann, R. Suzanne;Rusch, Valerie W.;Turrisi, Andrew T., III;Shepherd, Frances A.;Smith, Colum;Chen, Yuhchyau;Livingston, Robert B.;Feins, Richard H.;Gandara, David R.;Fry, Willard A.;Darling, Gail;Johnson, David H.;Green, Mark R.;Miller, Robert C.;Ley, Joanne;Sause, Willliam T.;Cox, James D.
通讯作者：
Cox, James D.
影响因子：
45.3
作者：
Lee, JS;Scott, C;Curran, WJ
通讯作者：
Curran, WJ
影响因子：
20.4
作者：
Onishi, Hiroshi;Shirato, Hiroki;Araki, Tsutomu
通讯作者：
Araki, Tsutomu
DOI：
10.1016/s0360-3016(00)00420-x
发表时间：
2000-07-01
影响因子：
7
作者：
Choy, H;Devore, RF;Johnson, DH
通讯作者：
Johnson, DH