Käsmann Lukas, Janssen Stefan, Schild Steven E, Rades Dirk
Department of Radiation Oncology, University of Lübeck, Lübeck, Germany.
Department of Radiation Oncology, University of Lübeck, Lübeck, Germany Medical Practice for Radiotherapy and Radiation Oncology, Hannover, Germany.
Anticancer Res. 2016 Mar;36(3):1089-91.
Radiochemotherapy for small-cell lung cancer may not be sufficiently tolerated by all patients. To contribute to better personalization of the radiochemotherapy programs, this study compared two radiotherapy doses and 10 characteristics for survival.
In 71 patients receiving radiochemotherapy for small-cell lung cancer, the radiation dose given as equivalent dose in 2 Gy fractions (EQD2: <56 vs. ≥56 Gy) plus 10 characteristics, namely gender, age, Karnofsky performance score, T-category, N-category, tumor stage, pack years, smoking during radiotherapy, respiratory insufficiency and hemoglobin prior to radiotherapy, were evaluated for survival.
On multivariate analysis, EQD2 ≥56 Gy (p=0.003), female gender (p=0.029), Karnofsky performance score >70 (p<0.001), very limited disease (p=0.043) and pre-radiotherapy hemoglobin ≥12 g/dl (p=0.044) were significantly associated with better survival.
This study identified several independent predictors of survival after radiochemotherapy of small-cell lung cancer. A radiation dose of ≥56 Gy resulted in better survival than lower doses.
并非所有小细胞肺癌患者都能充分耐受放化疗。为了更好地实现放化疗方案的个性化，本研究比较了两种放疗剂量以及与生存相关的10项特征。
对71例接受小细胞肺癌放化疗的患者，评估其以2 Gy分次等效剂量（EQD2：<56 Gy与≥56 Gy）表示的放疗剂量，以及10项特征，即性别、年龄、卡氏功能状态评分、T分类、N分类、肿瘤分期、吸烟包年数、放疗期间吸烟情况、呼吸功能不全以及放疗前血红蛋白水平，以分析其与生存的关系。
多因素分析显示，EQD2≥56 Gy（p = 0.003）、女性（p = 0.029）、卡氏功能状态评分>70（p<0.001）、疾病范围非常局限（p = 0.043）以及放疗前血红蛋白≥12 g/dl（p = 0.044）与更好的生存显著相关。
本研究确定了小细胞肺癌放化疗后生存的几个独立预测因素。≥56 Gy的放疗剂量比低剂量放疗能带来更好的生存效果。
