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[局部晚期非小细胞肺癌患者同步放化疗的疗效]

[Outcome of concurrent chemoradiotherapy in locally advanced non-small-cell lung cancer patients].

作者信息

Liu Lipin, Wang Xiaozhen, Ji Zhe, Wang Jingbo, Bi Nan, Hui Zhouguang, Lyu Jima, Liang Jun, Zhou Zongmei, Feng Qinfu, Chen Dongfu, Zhang Hongxing, Xiao Zefen, Yin Weibo, Wang Lühua

机构信息

Department of Radiation Oncology, Cancer Hospital (Institute), Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.

Department of Radiation Oncology, Cancer Hospital (Institute), Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China; Email:

出版信息

Zhonghua Zhong Liu Za Zhi. 2015 Nov;37(11):863-7.

PMID:26887520

Abstract

OBJECTIVE

To analyze the efficacy and toxicity of concurrent chemoradiotherapy (CCRT) for patients with locally advanced non-small-cell lung cancer (LA-NSCLC).

METHODS

Clinical data of 251 patients with stage III (76 IIIA and 175 IIIB) NSCLC who received CCRT as initial treatment between Jan 2001 and Dec 2010 in our hospital were reviewed. A median total radiotherapy dose of 60 Gy (range, 50-74 Gy) were delivered. 174 patients were treated with IMRT, 51 with 3D-CRT and 26 with 2D-radiotherapy. EP chemotherapy regimen was administered in 112 patients, PC regimen in 99 patients, topotecan regimen in 18 patients and other regimens in the remaining 22 patients. The efficacy and toxicity of CCRT were retrospectively analyzed.

RESULTS

244 patients were assessable for response, including 6 (2.5%) patients with CR, 183 (75.0%) with PR, 42 (17.2%) with SD and 13 (5.3%) with PD. At a median follow-up period of 20 months, the 1-, 3-, 5- year OS were 69.2%, 31.2%, 23.2%, respectively, and the median OS was 21 months. The 1-, 3-, 5- year PFS were 40.9%, 22.1%, 17.7%, respectively, and the median PFS was 10 months. Patients with stage IIIA NSCLC achieved better 5-year OS than that with IIIB NSCLC (29.2% vs. 20.7%, χ2=2.254, P=0.133). Failure pattern was assessable in 244 patients, including 61 (25.0%) locoregional progression alone, 55 (22.5%) distant metastasis alone and 77 (31.6%) with both. The rates of grade≥3 radiation pneumonitis, esophagitis and hematologic toxicity were 4.4%, 11.2% and 26.4%, respectively.

CONCLUSIONS

CCRT provide stage III NSCLC patients favorable outcome with acceptable toxicity. CCRT is standard therapeutic approach for patients with unresectable locally advanced NSCLC.

摘要

目的

分析同步放化疗（CCRT）治疗局部晚期非小细胞肺癌（LA-NSCLC）患者的疗效和毒性。

方法

回顾性分析2001年1月至2010年12月在我院接受CCRT作为初始治疗的251例III期（76例IIIA期和175例IIIB期）NSCLC患者的临床资料。放疗总剂量中位数为60 Gy（范围50-74 Gy）。174例患者接受调强放疗（IMRT），51例接受三维适形放疗（3D-CRT），26例接受二维放疗（2D-放疗）。112例患者采用EP化疗方案，99例采用PC方案，18例采用拓扑替康方案，其余22例采用其他方案。对CCRT的疗效和毒性进行回顾性分析。

结果

244例患者可评估疗效，其中完全缓解（CR）6例（2.5%），部分缓解（PR）183例（75.0%），疾病稳定（SD）42例（17.2%），疾病进展（PD）13例（5.3%）。中位随访20个月，1年、3年、5年总生存率（OS）分别为69.2%、31.2%、23.2%，中位OS为21个月。1年、3年、5年无进展生存率（PFS）分别为40.9%、22.1%、17.7%，中位PFS为10个月。IIIA期NSCLC患者的5年OS优于IIIB期NSCLC患者（29.2%对20.7%，χ2=2.254，P=0.133）。244例患者可评估失败模式，其中单纯局部区域进展61例（25.0%），单纯远处转移55例（22.5%），两者均有77例（31.6%）。≥3级放射性肺炎、食管炎和血液学毒性发生率分别为4.4%、11.2%和26.4%。