Receipt of thoracic radiation therapy and radiotherapy dose are correlated with outcomes in a retrospective study of three hundred and six patients with extensive stage small-cell lung cancer
Receipt of thoracic radiation therapy and radiotherapy dose are correlated with outcomes in a retrospective study of three hundred and six patients with extensive stage small-cell lung cancer
复制标题
一项针对 306 名广泛期小细胞肺癌患者的回顾性研究表明，接受胸部放射治疗和放射治疗剂量与结果相关
DOI：
10.1016/j.radonc.2017.10.005
复制
发表时间：
2017-11-01
影响因子：
5.7
通讯作者：
Wang, Ping
中科院分区：
文献类型：
--
作者：
Xu, Li-Ming;Zhao, Lu-jun;Wang, Ping
背景资料：胸部放射治疗（TRT）剂量的重要性尚未明确定义在广泛期小细胞肺癌（ES-SCLC），目前还不清楚是否提高TRT剂量转化为生存benefit.Methods：306例ES-SCLC患者进行回顾性分析，其中170例接受调强放疗/CRT分割RT后ChT，和136接受化疗（ChT）单独。我们采用时间调整的BED（tBED）进行有效剂量分割计算。由于这项研究的非随机性质，我们比较了ChT + RT与ChT组匹配可能的混淆variables.Results：患者实现2年OS，PFS和LC率分别为19.7%，10.7%和28.4%。倾向评分匹配后，（每组113例），ChT + TRT组2年OS、PFS和LC的发生率分别为21.4%、7.7%和34.5%，而ChT组仅为10.3%（p < 0.001）、4.6%（p < 0.001）和6.3%（p < 0.001）。在倾向评分匹配的患者中，每组56例接受高剂量（tBED > 50戈伊）TRT和低剂量（tBED < 50戈伊）TRT。高剂量组2年OS、PFS和LC率分别为32.3%、15.3%和47.1%，而低剂量组分别为17.0%（p < 0.001）、12.9%（p = 0.097）和34.7%（p = 0.029）。我们的研究结果表明，高剂量胸部放射治疗可能是一个合理的考虑与ES-SCLC患者的选择。(C)2017爱思唯尔B. V.保留所有权利。
Background: The importance of the thoracic radiation therapy (TRT) dose has not been clearly defined in extensive stage small-cell lung cancer (ES-SCLC) and it is unclear whether improved TRT dose translates into a survival benefit.Methods: 306 patients with ES-SCLC were retrospectively reviewed, of which 170 received IMRT/CRT fractionation RT after ChT, and 136 received chemotherapy (ChT) alone. We adopted the time-adjusted BED (tBED) for effective dose fractionation calculation. Due to the nonrandomized nature of this study, we compared the ChT + RT with ChT groups that matched on possible confounding variables.Results: Patients achieved 2-year OS, PFS and LC rates of 19.7%, 10.7% and 28.4%, respectively. After propensity score matching, (113 cases for each group), the rates of OS, PFS and LC at 2 years were 21.4%, 7.7% and 34.5% for ChT + TRT, and 10.3% (p < 0.001), 4.6% (p < 0.001) and 6.3% for ChT only (p < 0.001), respectively. Among propensity score matching patients, 56 cases for each group received the high dose (tBED > 50 Gy) TRT and received low dose (tBED < 50 Gy) TRT. Two-year OS, PFS and LC rates were 32.3%, 15.3% and 47.1% for the high dose compared with 17.0% (p < 0.001), 12.9% (p = 0.097) and 34.7% (p = 0.029) for low dose radiotherapy.Conclusions: TRT added to ChT improved ES-SCLC patient OS. High dose TRT improved OS over lower doses. Our results suggest that high-dose thoracic radiation therapy may be a reasonable consideration in select patients with ES-SCLC. (C) 2017 Elsevier B.V. All rights reserved.