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接受放化疗的不可切除局部晚期非小细胞肺癌患者的长期随访:日本临床肿瘤学组试验(JCOG0003A)数据的回顾性分析

Long-term follow-up of patients with unresectable locally advanced non-small cell lung cancer treated with chemoradiotherapy: a retrospective analysis of the data from the Japan Clinical Oncology Group trials (JCOG0003A).

作者信息

Ohe Yuichiro, Ishizuka Naoki, Tamura Tomohide, Sekine Ikuo, Nishiwaki Yutaka, Saijo Nagahiro

机构信息

Department of Internal Medicine, National Cancer Center Hospital, National Cancer Center Research Institute, Chuo-ku, Tokyo 104-0045, Japan.

出版信息

Cancer Sci. 2003 Aug;94(8):729-34. doi: 10.1111/j.1349-7006.2003.tb01510.x.

Abstract

To clarify the long-term survival data and factors that are correlated with survival outcome of unresectable locally advanced non-small cell lung cancer (NSCLC) following chemoradiotherapy, we analyzed patients who entered the Japan Clinical Oncology Group (JCOG) clinical trials for unresectable locally advanced NSCLC. Between October 1989 and August 1997, 240 patients (male 207, female 33; PS (performance status) 0 58, PS 1 172, PS 2 9, unknown 1; stage IIB 2, IIIA 62, IIIB 175, unknown 1) entered the 6 trials. All patients received chemotherapy and radiotherapy. The associations between survival outcome and treatment-related factors were analyzed using Cox regression analysis. Median survival times and 5-year survival rates in the trials were 11.9-19.7 months and 0-17.6%, respectively. Median survival time was 16.1 months and the 5- and 7-year survival rates of all 240 patients were 14.4% and 12.0%, respectively. No deaths were observed 7 years after initiation of the treatment or later. For stage IIIA and IIIB patients, the 5-year survival rates were 16.3% and 13.4%, respectively. Node status and age were significantly associated with survival, but no factors of the treatment were associated with survival of patients with unresectable locally advanced NSCLC. The present retrospective analysis showed that approximately 12% of patients with unresectable locally advanced NSCLC could be cured by various chemoradiotherapy regimens.

摘要

为了阐明不可切除的局部晚期非小细胞肺癌(NSCLC)放化疗后的长期生存数据及与生存结果相关的因素,我们分析了进入日本临床肿瘤学会(JCOG)不可切除局部晚期NSCLC临床试验的患者。1989年10月至1997年8月期间,240例患者(男性207例,女性33例;体能状态(PS)0分58例,PS 1分172例,PS 2分9例,不明1例;IIB期2例,IIIA期62例,IIIB期175例,不明1例)进入了6项试验。所有患者均接受了化疗和放疗。采用Cox回归分析生存结果与治疗相关因素之间的关联。试验中的中位生存时间和5年生存率分别为11.9 - 19.7个月和0 - 17.6%。中位生存时间为16.1个月,240例患者的5年和7年生存率分别为14.4%和12.0%。治疗开始7年后及以后未观察到死亡病例。对于IIIA期和IIIB期患者,5年生存率分别为16.3%和13.4%。淋巴结状态和年龄与生存显著相关,但治疗因素与不可切除局部晚期NSCLC患者的生存无关。本次回顾性分析表明,约12%的不可切除局部晚期NSCLC患者可通过各种放化疗方案治愈。

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