Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
Department of Thoracic Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
Radiother Oncol. 2016 Mar;118(3):447-52. doi: 10.1016/j.radonc.2016.02.008. Epub 2016 Feb 15.
Concurrent chemoradiotherapy (CCRT) is the standard treatment in locally advanced non-small cell lung cancer (NSCLC) patients. In clinical practice, the primary tumor (PT) and involved lymph nodes (LNs) receive the same radiotherapy dose. This study investigates differences between local failure (LF) and regional failure (RF).
Patients were irradiated with 66 Gy in 24 fractions (using IMRT) combined with daily low dose cisplatin. The PT and LNs were contoured on the planning CT-scan registered with a (18)FDG-PET-scan. Log10(Volume) and SUVmax of PT and LNs, location (LNs versus PT), performance status, age and gender were tested as prognostic factors for lesion failure using cox regression analysis.
In total, 226 patients were analyzed. LF or RF as first event was seen in 37 PT (16%) and 14 LNs (6%). Log10(Volume), location and SUVmax were significantly associated with failure in univariate analysis. In multivariate analysis, only log10(Volume) remained as a significant factor.
A LF and RF as first event of respectively 16% and 6% were observed in locally advanced NSCLC patients treated with CCRT. This difference was primarily associated with the difference in log10(Volume) of the primary tumor and lymph nodes.
同期放化疗（CCRT）是局部晚期非小细胞肺癌（NSCLC）患者的标准治疗方法。在临床实践中，原发肿瘤（PT）和受累淋巴结（LNs）接受相同的放射治疗剂量。本研究旨在探讨局部失败（LF）和区域失败（RF）之间的差异。
患者接受 66 Gy/24 次分割的放疗（采用 IMRT），联合每日低剂量顺铂治疗。在与（18）FDG-PET 扫描配准的计划 CT 扫描上勾画 PT 和 LNs。使用 Cox 回归分析，对数（体积）和 PT 和 LNs 的 SUVmax、位置（淋巴结与 PT）、表现状态、年龄和性别作为病变失败的预后因素进行测试。
共分析了 226 例患者。37 例 PT（16%）和 14 例 LNs（6%）出现 LF 或 RF 作为首发事件。在单因素分析中，对数（体积）、位置和 SUVmax 与失败显著相关。在多因素分析中，只有对数（体积）仍然是一个显著的因素。
局部晚期 NSCLC 患者接受 CCRT 治疗后，LF 和 RF 作为首发事件的发生率分别为 16%和 6%。这种差异主要与原发肿瘤和淋巴结的对数（体积）差异有关。
