Effect of histologic type on recurrence pattern in radiation therapy for medically inoperable patients with stage I non-small-cell lung cancer
Effect of histologic type on recurrence pattern in radiation therapy for medically inoperable patients with stage I non-small-cell lung cancer
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DOI：
10.1007/s00408-006-0012-5
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发表时间：
2006-12-01
期刊：
影响因子：
5
通讯作者：
Nakano, Takashi
中科院分区：
文献类型：
--
作者：
Ishikawa, Hitoshi;Nakayama, Yuko;Nakano, Takashi
日本的随机试验显示，在完全切除术后使用尿嘧啶-替加氟辅助化疗对I期肺腺癌（AD）的生存率有显著影响，但对鳞状细胞癌（SQ）患者无影响。本研究的目的是检查肿瘤组织学和放射治疗（RT）的I期非小细胞肺癌（NSCLC）的临床结果的相关性，并考虑这些患者RT后辅助化疗的必要性。受试者为83例患者，54例SQ和29例AD患者;他们接受了总剂量为60至80戈伊的常规分次放射治疗，每日剂量为2戈伊。SQ和AD之间的生存和复发模式的差异进行了研究。5年总生存率和病因特异性生存率分别为26.5%和49.1%。SQ和AD患者的生存率无差异，复发率几乎相同（SQ为44%，AD为45%）。然而，SQ的5年一级控制率显著低于AD（SQ：61.5%; AD：87.6%; p = 0.03）。相反，SQ的5年无转移生存率显著优于AD（SQ：88.2%; AD：53.0%; p = 0.005）。不同的失败模式，根据肿瘤组织学，表明考虑到他们的临床行为的差异也将是重要的规划RT和手术的早期肺癌。
Japanese randomized trials showed that there was a significant impact on survival from stage I adenocarcinoma (AD) of the lung by adjuvant chemotherapy with uracil-tegaful after complete resection but there was no effect for patients with squamous cell carcinoma (SQ). The purpose of this study was to examine the correlation of tumor histology and clinical outcome of radiation therapy (RT) for stage I non-small-cell lung cancer (NSCLC) and to consider the necessity of adjuvant chemotherapy after RT for these patients. The subjects were 83 patients, 54 with SQ and 29 with AD; they had received definitive RT with the total dose ranging from 60 to 80 Gy with conventional fractionation at a daily dose of 2 Gy. The differences between SQ and AD with respect to survival and recurrence pattern were investigated. The 5-year overall survival and cause-specific survival rates were 26.5% and 49.1%, respectively. No difference in survival was observed between SQ and AD patients, and the recurrence rates were almost identical (44% for SQ and 45% for AD). However, the 5-year primary control rate of SQ was significantly poorer than that of AD (SQ: 61.5%; AD: 87.6%; p = 0.03). Conversely, the 5-year metastasis-free survival rate of SQ was significantly better than that of AD (SQ: 88.2%; AD: 53.0%; p = 0.005). The different failure pattern, according to tumor histology, indicates that taking into consideration the difference in their clinical behaviors would also be important for planning RT and surgery for early lung cancer.