High-dose radiation improved local tumor control and overall survival in patients with inoperable/unresectable non-small-cell lung cancer: Long-term results of a radiation dose escalation study
High-dose radiation improved local tumor control and overall survival in patients with inoperable/unresectable non-small-cell lung cancer: Long-term results of a radiation dose escalation study
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DOI：
10.1016/j.ijrobp.2005.02.010
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发表时间：
2005-10-01
影响因子：
7
通讯作者：
Hayman, JA
中科院分区：
文献类型：
--
作者：
Kong, FM;Ten Haken, RK;Hayman, JA
用途：为了确定高剂量放射治疗是否会改善非小细胞肺癌（NSCLC）患者的预后，方法和材料：本分析包括106例新诊断或复发的I-III期NSCLC患者，采用三维适形放射治疗（3D-CRT），剂量递增试验，每2.1-戈伊分次给予63-103戈伊治疗。目标包括原发性肿瘤和任何>= 1 cm的淋巴结，而不故意包括阴性淋巴结区域。19%的患者（20/106）接受了新辅助化疗。评估患者、肿瘤和治疗因素与结局的相关性。结果：中位生存期为19个月，5年总生存率（OS）为13%。多变量分析显示，体重减轻（p = 0.011）和放射剂量（p = 0.0006）是OS的重要预测因素。接受63-69、74-84和92-103戈伊治疗的患者的5年OS分别为4%、22%和28%。虽然在单变量分析中，淋巴结疾病的存在与局部控制呈负相关，但当包括多个变量时，辐射剂量是唯一显著的预测因子（p = 0.015）。63-69、74-84和92-103戈伊的5年控制率分别为12%、35%和49%，respectively.Conclusions：在63-103戈伊范围内接受治疗的NSCLC患者中，高剂量放疗与预后改善相关。(c)2005年爱思唯尔公司
Purpose: To determine whether high-dose radiation leads to improved outcomes in patients with non-small-cell lung cancer (NSCLC).Methods and Materials: This analysis included 106 patients with newly diagnosed or recurrent Stages I-III NSCLC, treated with 63-103 Gy in 2.1-Gy fractions, using three-dimensional conformal radiation therapy (3D-CRT) per a dose escalation trial. Targets included the primary tumor and any lymph nodes >= 1 cm, without intentionally including negative nodal regions. Nineteen percent of patients (20/106) received neoadjuvant chemotherapy. Patient, tumor, and treatment factors were evaluated for association with outcomes. Estimated median follow-up was 8.5 years.Results: Median survival was 19 months, and 5-year overall survival (OS) was 13%. Multivariate analysis revealed weight loss (p = 0.011) and radiation dose (p = 0.0006) were significant predictors for OS. The 5-year OS was 4%, 22%, and 28% for patients receiving 63-69, 74-84, and 92-103 Gy, respectively. Although presence of nodal disease was negatively associated with locoregional control under univariate analysis, radiation dose was the only significant predictor when multiple variables were included (p = 0.015). The 5-year control rate was 12%, 35%, and 49% for 63-69, 74-84, and 92-103 Gy, respectively.Conclusions: Higher dose radiation is associated with improved outcomes in patients with NSCLC treated in the range of 63-103 Gy. (c) 2005 Elsevier Inc.