Analysis of first recurrence and survival in patients with stage I non-small cell lung cancer treated with surgical resection or stereotactic radiation therapy.
Analysis of first recurrence and survival in patients with stage I non-small cell lung cancer treated with surgical resection or stereotactic radiation therapy.
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DOI：
10.1016/j.jtcvs.2013.11.057
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发表时间：
2014-04
影响因子：
6
通讯作者：
Meyers, Bryan F.
中科院分区：
文献类型：
--
作者：
Crabtree, Traves D.;Puri, Varun;Robinson, Clifford;Bradley, Jeffrey;Broderick, Stephen;Patterson, G. Alexander;Liu, Jingxia;Musick, Joanne F.;Bell, Jennifer M.;Yang, Michael;Meyers, Bryan F.
由于缺乏对非小细胞肺癌(NSCLC)匹配队列之间复发模式的比较，立体定向全身放射治疗(SBRT)和手术之间的生存率比较研究一直受到限制。对2004年6月至2010年12月期间所有接受手术或SBRT治疗的临床I期非小细胞肺癌患者进行回顾。收集年龄、肿瘤特征、合并症评分、肺功能、总体(OS)、无病生存期(DFS)和复发数据，并进行倾向匹配。平均手术年龄(n=45 8)为65.8±10.5vs.74.4±9.4(P<0.0 1)。在整个手术队列中，3年OS和DFS分别为78%和72%。在整个SBRT队列中，3年OS和DFS分别为47%和42%。手术总的局部复发率为2.6%。SBRT组局部复发率为10.7%。根据年龄、肿瘤大小、血管紧张素转换酶合并症评分、FEV1%和肿瘤部位进行倾向匹配比较，得到56对匹配结果。SBRT组和手术组的3年总生存率分别为52%和68%(p=0.05)，无瘤生存率分别为47%和65%(p=0.01)。3年后，SBRT和手术的局部无复发生存率分别为90%和92%(p=0.07)，尽管手术切除似乎比SBRT有更好的总体和无病生存率，但匹配这些不同的患者队列仍然具有挑战性。参与临床试验对于确定I期非小细胞肺癌高危人群手术和放射治疗的适应症和相对疗效至关重要。
Comparative studies of survival between stereotactic body radiation therapy (SBRT) and surgery have been limited by lack of comparisons of recurrence patterns between matched cohorts in non-small cell lung cancer (NSCLC). All patients undergoing treatment with surgery or SBRT for clinical Stage I NSCLC between June 2004-December 2010 were reviewed. Age, tumor characteristics, comorbidity score, pulmonary function, overall (OS) and disease free survival (DFS) and recurrence data were collected and propensity matching performed.. The mean age for surgery (N=458) was 65.8 ± 10.5 vs. 74.4 ± 9.4 for SBRT (N=151) (p<0.0001). For the entire surgical cohort 3-year OS and DFS were 78% and 72%, respectively. For the entire SBRT cohort 3-year OS and DFS were 47% and 42%, respectively. The overall local recurrence rate for surgery was 2.6%. The overall local recurrence rate for SBRT was 10.7%. A propensity matched comparison based on age, tumor size, ACE comorbidity score, FEV1%, and tumor location resulted in 56 matched pairs. The 3-year overall survival was 52% vs. 68% for SBRT and surgery, respectively (p=0.05) while disease-free survival was 47% vs. 65% (p=0.01). At 3 years, local recurrence free survival was 90% vs. 92% for SBRT and surgery, respectively (p=0.07) While surgical resection seems to result in better overall and disease free survival vs. SBRT, matching these disparate cohorts of patients remains challenging. Participation in clinical trials is essential to define the indications and relative efficacy of surgery and radiation therapy in a high-risk population with Stage I NSCLC.
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DOI：
10.1016/j.ijrobp.2011.01.038
发表时间：
2011-11-15
影响因子：
7
作者：
Olsen, Jeffrey R.;Robinson, Clifford G.;Bradley, Jeffrey D.
通讯作者：
Bradley, Jeffrey D.
DOI：
10.1016/j.jtcvs.2012.06.003
发表时间：
2012-09
期刊：
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影响因子：
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作者：
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通讯作者：
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影响因子：
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作者：
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通讯作者：
Ragona, Riccardo
影响因子：
9.6
作者：
Darling, Gail E.;Allen, Mark S.;Putnam, Joe B., Jr.
通讯作者：
Putnam, Joe B., Jr.
DOI：
10.1016/j.jtcvs.2012.10.038
发表时间：
2013-03-01
影响因子：
6
作者：
Crabtree, Traves;Puri, Varun;Meyers, Bryan
通讯作者：
Meyers, Bryan